Did you know…

Did you know the death rate for breast cancer for Canadian women has dropped by 25 per cent since 1986?

A Canadian Cancer Society special report in Canadian Statistics 2007 says increased participation in organized breast screening programs (particularly by women aged 50 to 69) has led to earlier detection and made it more likely that patients who have breast cancer receive successful treatment (CMAJ June 19, 2007).

The national recommendation is that organized breast cancer screening programs actively screen women aged 50 to 69 every two years. Organized screening programs began in British Columbia in 1988 and have since expanded to include all provinces, the Yukon and the Northwest Territories.

If you are under 50 years of age or 70 and over then discuss your risks and screening program with your physician.

The screening program includes mammogram, clinical examination of your breasts by your physician every two years and monthly breast self-examination.

Did you know that early diagnosis and treatment of prostate cancer was first suggested a century ago?

Although prostate-specific antigen (PSA) blood test has been widely used in North America to detect early prostate cancer, it is still unknown whether PSA screening significantly reduces mortality from prostate cancer.

Actually PSA measurements reflect cancer risk, with the risks of cancer and of aggressive cancer increasing with the level of PSA (CMAJ June 19, 2007). Besides PSA blood level, your physician will look at other risk factors before he can advise you on further management. Other risk factors are: family history of prostate cancer, digital rectal examination findings, age, ethnicity and history of previous biopsy with a negative result.

Since PSA test is not a perfect test for detecting early prostate cancer, you should discuss with your doctor the risks and benefits of ordering such a test. PSA blood test for screening is not recommended by the Canadian Task Force on Preventive Health Care as there is insufficient evidence to promote it for screening for early detection of prostate cancer. Canadian Urological Association and Prostate Cancer Alliance have recommended that it be performed only after detailed discussion of the pros and cons between doctor and patient.

What is interesting is that recent nationwide survey indicated that almost half of Canadian men over 50 years of age reported receiving PSA screening during their lifetime. PSA blood test and digital rectal examination have become part of annual physical examination for men over 50 by their family physician and 72 per cent of these men had these tests in the last one year (CMAJ).

Prostate cancer is thought to be the disease of older men. But autopsy studies have found that 27 per cent of men in their 30s and 34 per cent of men in their 40s have histological evidence of the disease (not necessarily clinically known disease). The current lifetime risk of disease diagnosis is 18 per cent and lifetime risk of dying from prostate cancer is three per cent.

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