I know some of my colleagues — and readers — may disagree with me when it comes to cancer screening recommendations. But for me, routine guidelines really are one of those grey areas.
I’m not against cancer screening. I may take issue with some of the most popular methods used. (Hello, mammograms!) But if anything, I worry that patients don’t take screening recommendations seriously enough.
And they could be losing their lives far too early because of it…
Compliance will keep you alive
This “news” is hardly surprising on the surface. Regular cancer screening and timely treatment plans keeps people alive. And when the guidelines aren’t being followed, more people die.
That was the takeaway of the latest analysis of the Prostate, Lung, Colorectal and Ovarian Cancer Screening (PLCO) trial. And it showed that ignoring recommended tests significantly increased all-cause mortality.
Over a decade of follow-up, mortality rates were dramatically higher among subjects who didn’t take routine screening recommendations seriously, as compared to subjects who were fully compliant.
And when I say the difference was dramatic, I mean it: Even after excluding cancer deaths — and controlling for factors like age, sex, and ethnicity — death rates were nearly 75 percent higher among non-compliant subjects. Partial adherence was dangerous, too — raising mortality by more than a third.
In other words, not following cancer screening guidelines is as life-threatening as morbid obesity.
Granted, part of the issue could be that patients who aren’t getting regular screenings are more likely to neglect all areas of their health. But I can tell you from my own patient population that there are plenty of health nuts who let screening tests slide, too.
So if you’re not being proactive about regular screenings, let’s take a minute to talk about exactly how you can change that.
Cancer screenings to schedule today
The PLCO trial addresses four different types of cancer — and four different sets of screening guidelines. Let’s take a minute to review my basic recommendations for each:
- Prostate cancer. This screen couldn’t be simpler — just a rectal exam and PSA, PCA-3, and 4K scores. In other words, a quick finger up the rear and some simple blood work.
- Lung cancer. No one recommends routine chest X-rays and CT scans. But if you’re a former or current smoker, or you have a long history of exposure to second-hand smoke, you should insist on this kind of imaging. And dependent on your smoking history, you can talk to your doctor about how often you should get screened.
- Colorectal cancer. As you may recall, there’s a strong history of this disease among the men in my family — so I get a routine colonoscopy every three years. That may be excessive for your average-risk patient. Which is why I strongly advise regular screenings with less invasive tests like Cologuard, at a minimum. A negative Cologuard result means you won’t have to worry for another three years.
- Ovarian cancer. A simple pap smear and a transvaginal ultrasound are fairly non-invasive — and potentially life-saving. Especially if you’re on hormone replacement therapy, underwent fertility treatment, took birth control pills, or have any family history of the disease.
Those are my default guidelines, both for myself and my patients. And they should be yours, too — because clearly, following them is a matter of life and death.
I discuss more options for cancer screening — as well as my simple, science-based strategies to fortify your cellular defenses and stop cancer in its tracks — in my Essential Protocol to a Cancer-Free Future. Click here to learn more, or sign up today.Until next time, Dr. Fred