CANCER:

Cancer death rates are decreasing over time. According to the CDC, from 2001 to 2020 cancer death rates went down 27%, and continue to decrease. Even still... CANCER IS THE SECOND LEADING CAUSE OF DEATH IN THE US - ONE IN EVERY 4 DEATHS IS DUE TO CANCER.

Leading causes of new cancer cases (2019 CDC data):

1)Female Breast, 2)Prostate, 3)Lung, 4)Colorectal, 5)Uterine, 6)Melanoma, 7)Urinary/Bladder, 8)Non-Hodgkin Lymphoma, 9)Kidney, 10)Leukemias

NATIONAL AVERAGE - NEW CANCER DIAGNOSES: 439 per 100,000

STATE WITH HIGHEST FREQUENCY OF NEW CANCER DIAGNOSES: KENTUCKY (504.9 per 100,000)

STATE WITH LOWEST FREQUENCY OF NEW CANCER DIAGNOSES: ARIZONA (358.7 per 100,000)

MISSOURI - 442.5 per 100,000

KANSAS - 452.2 per 100,000

Leading causes of death from cancer in the USA (2019 CDC data):

1.Lung, 2.Female Breast, 3.Prostate, 4.Colorectal 5.Pancreatic, 6.Liver/Bile Duct, 7.Ovarian, 8.Leukemia, 9.Uterine, 10.Non-Hodgkin Lymphoma

NATIONAL AVERAGE - CANCER DEATHS: 144.1 per 100,000

STATE WITH HIGHEST FREQUENCY OF CANCER DEATHS: KENTUCKY (177.3 per 100,000)

STATE WITH LOWEST FREQUENCY OF CANCER DEATHS: UTAH (119.5 per 100,000)

MISSOURI - 157.9 per 100,000

KANSAS - 151.4 per 100,000

SCREENING RECOMMENDATIONS:

BLADDER CANCER - 4th most common cancer in men, 9th in women

--> insufficient evidence to assess benefits vs harm in screening (basic urine test) for those without symptoms

-->WHY? MANY FALSE POSITIVE RESULTS, meaning unnecessary additional procedures/tests that may cause harm/excessive anxiety

--> Common Symptoms - blood in urine, or other sudden change or symptoms in the lower urinary tract

BREAST CANCER - 2nd-leading cause of cancer deaths in women. Usually diagnosed at ages 55-64. Age is the most important risk factor.

--> WHEN TO SCREEN: Starting age 50 (but earlier depending on multiple factors)

--> MAMMOGRAM - recommended in women every other year, from ages 50-74 (before age 50 & beyond age 74 is case-by-case)

--> BRCA 1/2 genetic testing - RISK ASSESSMENT TOOL (to determine whether genetic counseling is necessary, and afterwards consider testing)

--> Routine breast self-exams are NOT recommended (high false-positive rate)

--> Risk-Reducing medications (estrogen blockers) are to be offered for women ages 35+ who are at increased risk of breast cancer

CERVICAL CANCER - decreasing in the USA, as of 2015 down to 2.3 deaths per 100,000 persons

--> WHEN TO SCREEN: Starting at age 21

--> Cervical Cytology (Speculum Exam or "PAP" test) recommended every 3 years ages 21-29

--> Pap every 3 years ages 30-65 years, OR Pap + high-risk HPV virus testing every 5 years

--> Screening is NOT recommended for: age<21, age>65, or in women with hysterectomy but NO history of high-grade precancerous lesions.

COLON (COLORECTAL) CANCER - 3rd leading cause of cancer death in men and women, usually diagnosed ages 65-74.

*Currently 31.2% of adults are NOT up to date with screening**!

--> WHEN TO SCREEN: Starting at age 45 (or 10 years prior to diagnosis in a first-degree relative)

--> GOLD STANDARD = colonoscopy screening (every 10 years unless otherwise specified)

--> Other Options:

-----> Cologard (DNA-FIT testing) every 1-3 years

-----> High-Sensitivity Guaiac Fecal Occult Blood Test (HSgFOBT) or Fecal Immunochemical Test (FIT) every year

-----> Flexible Sigmoidoscopy every 5 years (or every 10 years when added with FIT test)

-----> CT colonography every 5 years

--> Use of Aspirin for colorectal cancer prevention is not recommended (multiple studies show no net benefit)

LUNG CANCER - 2nd most diagnosed cancer, currently the leading cause of cancer death. Most important risk factor: SMOKING (any type) which accounts for 90% of all new diagnoses. Average age at diagnosis: 70 years

**--> WHEN TO SCREEN: Age 50 (in smokers who have smoked 20-pack years*)**

--> Annually screen ages 50-80 with 20-pack year history (stops early when a person has been smoke-free for 15 years)

*20-pack years means 1 pack per day for 20 years, 2 packs a day for 10 years, 1/2 pack per day for 40 years, etc.

ORAL & PHARYNGEAL CANCER (lip, mouth, nose, throat)

--> Biggest risk factors: Tobacco and alcohol use - these are declining over time

--> Other risk factors: HPV (usually from oral sex) - this is a rising risk factor

--> Inadequate evidence that screening for oral cancer improves lifespan or changes quality of life (need better methods to detect)

OVARIAN CANCER - 5th most common cause of cancer deaths among women (over 95% ages 45+, avg age 63)

--> CA-125 blood test has a low positive predictive value (positive test = more likely to NOT have ovarian cancer than have ovarian cancer)

--> Transvaginal Ultrasound can detect between 80-100% of ovarian cancers, however it is too difficult to determine cancer vs cysts or endometriosis

--> HIGH RISK INDIVIDUALS - especially BRCA 1 or 2 genetic mutation with high-risk family history (or Lynch syndrome) = screening recommended starting at age 30 (earlier in some cases) using both ultrasound AND CA-125 testing.

PANCREATIC CANCER - uncommon cancer, however this is the 3rd most common cause of cancer death in the USA.

--> Screening is NOT recommended for the general population

--> High risk individuals (family history, heredetary pancreatitis, Peutz-Jeghers syndrome, Lynch syndrome) may undergo CT, MRI, or esophageal ultrasound

--> CA 19.9 biomarker (blood test) may be useful in high-risk individuals, but has a high false-positive rate (positive result, but no cancer present)

PROSTATE CANCER - common cancer in men. 33% of men age 70's have it (11% of men diagnosed in their lifetime, 2.5% overall risk of death)

--> Large majority of prostate cancer is non-invasive and not related to death in most cases

--> AAFP does not recommend PSA testing OR rectal exam (see THIS video about PSA testing)

--> The good: PSA testing prevents approximately 1.3 deaths per 1,000 individuals over a 13 year-span

--> The bad: A high false-positive rate (abnormal finding but no cancer) often leads to unnecessary biopsies, chronic pain, impotence, and other problems

PEPTIDE THERAPIES

LIVE YOUR LIFE TO THE FULLEST

FOR MEN

FOR WOMEN

Add Title

Add Title