A Preventable Cancer

(This article appeared in the September/October 2006 issue of The American Postal Worker magazine.)

Joyce B. Robinson, Research & Education Department Director

September is “Gynecological Cancer Awareness Month,” and women are strongly urged to get screened for the human papillomavirus (HPV), which is the cause of virtually all cervical cancer, and which can be prevented.

To avoid what was once the most deadly of the “women’s cancers,” yearly cervical testing should begin by age 21. Women younger than 30 should request a Pap test. If over 30, both a Pap and the HPV test are recommended.

Women 70 years of age or older who have had three or more normal Pap tests in a row and no abnormal Pap test results in the last 10 years, may choose to stop having cervical cancer testing.

The Food and Drug Administration announced on June 8 that it was expediting approval for the first vaccine against HPV. (For additional information, visit the American Cancer Society at www.cancer.org, or the National Cancer Institute at www.cancer.gov.)

The Highest Mortality

While the battle against that disease is being won, statistics for other cancers are sobering. There have been dramatic reductions in the mortality rates of most types, but there still is no “cure.” Early detection is always the best defense against the disease, and often is the only defense. Through early detection, many cancers can be held at bay and even avoided, most notably the most deadly of all — lung cancer. Breast, prostate, and colon/rectal cancers also have relatively high mortality rates.

Lung cancer claims more American lives — approximately 150,000 — each year than the other three most fatal types combined. And while smoking is the cause of nearly 90 percent of all lung cancers, many non-smokers also get the disease. Smokers have heard it all before: Ask your doctor or nurse to help you quit — and feel free to encourage others not to start.

Breast cancer can occur at any age, but most typically is seen in women over 40. Women in their 20s and 30s should have a clinical breast exam every three years; women 40 and older are advised to see a specialist every year. Women considered at risk because of a family history or known genetic tendency should look into being screened at an earlier age.

Almost all cases of prostate cancer occur in men older than 50 — more than 70 percent of the time it occurs in men over 65. African-Americans are more likely to develop the disease than are members of other groups, and are more than twice as likely as the rest of the population to die from it. A family history of prostate cancer means a man is at risk, and a diet high in animal fat is also a risk factor. Prostate cancer can usually be detected in its early stages by having a prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE) every year starting at age 50; at age 45 if you are at risk.

Colorectal cancers start out as a polyp in the colon or rectum, striking most often in people age 50 and older who have a family history of the cancer, or have had inflammatory bowel disease. Many people also develop harmless polyps that, if removed, may prevent this cancer. Eating a low-fat diet rich in fruits and vegetables may reduce your risk. Here are the tests recommended beginning at age 50: An annual fecal occult blood test (FOBT) or fecal immunochemical test (FIT); a flexible sigmoidoscopy every five years; and a colonoscopy every 10 years (more frequently for those at risk).

Gynecological Cancers

Taken together, gynecological cancers —mainly ovarian, uterine, and cervical — are the fifth most frequently diagnosed “fatal” cancers.

Ovarian cancer is the most deadly gynecological cancer; uterine cancer is the most common. Both tend to strike women who are older than 50. Risk factors for ovarian cancer include never having had children or having a first child after age 30. Uterine cancer risk factors include long-term estrogen-replacement therapy (overweight women tend to produce more estrogen), diabetes and high blood pressure, and the occurrence of other cancers. A yearly pelvic exam is recommended.