Cancer Archive

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Being checked for hidden colorectal cancer is a smart bet, though it's hard to say whether it will ultimately extend your life span.

Recently, the National Colorectal Cancer Roundtable—a national organization of medical groups, health care providers, government agencies, and patient advocates—launched the "80% by 2018" initiative. The goal is to convince more people to get screened for hidden colorectal cancer. Right now, about 65% of Americans do so.

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Women can devise their own breast cancer screening schedules based on their risk and preferences.

If you tend to "go by the book" for preventive health care, you probably get a flu shot each fall, have a colonoscopy every 10 years, and generally follow the experts' recommendations. But what do you do about mammograms? For decades, the two most influential expert groups—the American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF)—haven't agreed about when to start having mammograms, how often to have them, or how long to keep on having them. Although the two groups come a little closer together with their most recent guidelines, they still disagree about breast cancer screening for women ages 45 through 54.

Research we're watching

A study published Oct. 15, 2015, in the International Journal of Cancer adds to evidence that the risk of breast cancer increases—but not very much—with every drink a woman takes. Researchers from five Spanish universities followed 334,850 women, ages 35 to 70, from 10 European countries. During an 11-year period, 11,576 were diagnosed with breast cancer.

When the researchers compared alcohol intake among women who developed breast cancer and those who didn't, they found women who averaged two drinks a day had a 4% higher risk than those who limited their consumption to one daily drink. Those who averaged three drinks a day had a 6% higher breast cancer risk.

Ask the doctor

Q. I'm a 48-year-old woman, and I've never had a mammogram. Different guidelines seem to say different things. What do you recommend?

A. You're right, there are several different guidelines. Probably the two most often consulted by doctors are those of the U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS). Recent changes by the ACS bring its recommendations nearer to those of USPSTF. They disagree slightly about you. ACS says you should have a mammogram (because you are over 45), but USPSTF says to begin at age 50. Both expert committees stress that these recommendations apply only to women who are not at extra risk of breast cancer (extra risk includes, for example, having a parent, sibling, or child who's had breast cancer). If a woman is at extra risk, she should start getting mammograms earlier.

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News briefs

The guidelines for routine breast cancer screenings are changing again. The American Cancer Society (ACS) published its new recommendations Oct. 20, 2015, in The Journal of the American Medical Association, suggesting that women at average risk for breast cancer now wait until age 45 to begin getting yearly mammograms (it had been age 40) and then get yearly mammograms until age 54. After that, the ACS now recommends that average-risk women ages 55 to 74 transition to screening every other year (instead of annually). It's a big shift for the ACS, and the recommendations are now more in line with the guidelines that came from the U.S. Preventive Services Task Force (USPSTF) in 2009, which recommended mammograms every two years for average-risk women ages 50 to 74 and advise against routine screening before age 50 in these women. The USPSTF guidelines have been controversial since they came out. But no one is saying that women at increased risk for breast cancer should wait to get a mammogram; it's a decision that must be made by a woman and her doctor, based on her risk factors. One other big change to the ACS guidelines: that women continue screening mammography only if they have a life expectancy of 10 years or longer.

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Ask the Doctor

Q. I had a vasectomy many years ago, at age 45. I recently read that this increases my risk of prostate cancer. Should I be concerned?

A. Despite the reports you've heard about the connection between vasectomy and prostate cancer, the evidence is weak for a cause-and-effect relationship. Right now, this hypothetical risk should not cause you undue concern.

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Research we're watching

A preliminary study published Sept. 14, 2015, in JAMA Internal Medicine reported that older women in Spain who ate a traditional Mediterranean diet enhanced with extra-virgin olive oil were less likely to be diagnosed with breast cancer. The study was part of a large Spanish clinical trial, Prevención con Dieta Mediterránea (PREDIMED).

PREDIMED looked at three different groups of women. One followed the Mediterranean diet plus extra servings of olive oil. A second followed the diet plus extra servings of nuts. Those in the third group were ad-vised to reduce their fat intake. The study followed about 4,300 women ages 60 to 80 for five years.

A new study confirms that active surveillance is a safe and reasonable alternative to immediate treatment for prostate cancer. In recently published study that followed 1,300 men, the prostate cancer survival rate after 10-15 years of active surveillance, was 99%. For some men, a strong discomfort with “living with cancer” may steer them away from postponing treatment in favor of careful monitoring.

A new study confirms that active surveillance is a safe and reasonable alternative to immediate treatment for prostate cancer. In recently published study that followed 1,300 men, the prostate cancer survival rate after 10-15 years of active surveillance, was 99%. For some men, a strong discomfort with “living with cancer” may steer them away from postponing treatment in favor of careful monitoring.