How to prevent and detect common cancers in women

By Injil Abu Bakar

NEW YORK (JP): The cancers that most frequently affect women include breast, lung, colorectal, endometrial, ovarian, cervical, and skin cancers. Knowing about these cancers and how they can be prevented or detected early can save your life.

Breast Cancer

More and more women in the U.S. are diagnosed with breast cancer every year. This year, about 175,000 new cases are expected and an estimated 43,300 women will die of the disease.

Who is at risk?

Most women who get breast cancer have no family history of the disease or other risk factors. Breast cancer can occur at any age, but it becomes more common as a woman gets older.

Some women are at a higher risk: women whose mothers or sisters had breast cancer, women who have never had children, and women who had their first child after age 30.

Best defense: early detection

The earlier breast cancer is detected, the easier it is to treat. The American Cancer Society recommends the following guidelines for early detection :

For those aged 40 and over: * Have a mammogram every year * Have a clinical breast examination conducted by a health care professional every year * Self-examine your breasts each month.

For those aged 20 - 39: * Self-examine your breasts every month * Have a clinical breast examination performed by a health care professional every three years * The clinical breast examination should be done close in time to the scheduled mammogram.

Lung cancer

Lung cancer will claim the lives of about 68,000 women this year in the U.S., more than any other cancer. Perhaps the greatest tragedy of lung cancer is that it can be almost totally prevented, though it still kills many each year.

Who is at risk?

People who smoke are at a greater risk of getting lung cancer as well as a host of other tobacco-related diseases such as heart disease, stroke, and emphysema. About 87 percent of all lung cancers are caused by smoking. Other risk factors include exposure to radon, asbestos, and radiation, especially in smokers.

Best defense: Prevention

Lung cancer is one of the few cancers that can be prevented, because almost all of it is caused by smoking. If you are a smoker, ask your doctor to help you quit. If you don't smoke, don't start. If your friends and loved ones are smokers, help them quit.

Colorectal cancer

Colorectal cancer is a disease of the lower digestive tract. About 67,000 women in the U.S. are expected be diagnosed with it this year, and about 28,800 may die of the disease. Advances in the detection and treatment of this cancer have made it very treatable if caught early.

Who is at risk?

Anyone is at risk for colorectal cancer. People with a family history of the disease or who have polyps in the colon or rectum or inflammatory bowel disease are at somewhat greater risk than the general population. Diets that are high in fat and low in fiber place people at higher risk for colorectal cancer.

Best defense: early detection

Most colorectal cancer begins as polyps that become cancerous. These polyps can be detected and removed before they become cancerous. Colorectal cancer is a disease that can be prevented. Eating food that is low in fat and high in fiber appears to lower the risk of colorectal cancer.

The American Cancer Society recommends the following guidelines for early detection of colorectal cancer:

For those aged 50 and over, one of the following: Fecal occult blood test every year and flexible sigmoidescopy every five years or colonoscopy every 10 years or double-contrast barium enema every five to 10 years

Note: A digital rectal examination should be done at the same time as the sigmoidescopy, colonoscopy, or double-contrast barium enema. People at moderate or high risk for colorectal cancer should talk with their doctor about a different screening schedule.

Cervical cancer

About 12,800 cases of cervical cancer will be diagnosed this year in U.S. Most of these will be caught early and cured, although a third of these cases will still result in the patient's death. In certain groups of women, including women past the child-bearing years who do not regularly see a gynecologist, cervical cancer is more commonly found at an advanced stage when cure is less likely.

Who is at risk?

Cervical cancer can affect any woman who is, or has been, sexually active. Risk of cervical cancer is higher in women who have had multiple sexual partners. Older women and women without access to regular medical care are especially vulnerable if they do not have regular Pap tests and gynecological examinations. Other women at high risk are those infected with the human immunodeficiency virus (HIV), women with genital warts, and women who smoke.

Best defense: early detection

A Pap test can detect changes in the cervix that can be treated before it becomes cancerous. The Pap test is also very effective in detecting cervical cancer in its early stages before it has spread to other parts of the body, when it still remains highly curable.

The American Cancer Society recommends that all women who have reached the age of 18 or who have been sexually active have a Pap test and pelvic exam every year. After three or more normal exams, the Pap test may be performed less frequently at her doctor's discretion.

Ovarian cancer

Approximately 25,200 cases of ovarian cancer occur annually in the U.S. and it causes over 14,500 deaths a year, more than any other cancer of the female reproductive system. This is largely because it is a "silent" cancer with no obvious symptoms until its later stages.

Who is at risk?

As with most cancers, the risk of getting ovarian cancer increases with age. Women who have never had children, women who have a family history of ovarian cancer, and women who have had breast cancer are more at risk from this cancer.

However, most women who get ovarian cancer do not have any of these risk factors. Pregnancy, the use of oral contraceptives, and having a tubal ligation decrease the risk of ovarian cancer; the risk decreases as the number of pregnancies and the years of the use of oral contraceptives increases.

Best defense: Regular checkups

Periodic, thorough pelvic exams are important. Unfortunately, there is no effective and proven test for detecting the disease early, such as is the case with mammography and breast cancer. The Pap test, effective in detecting cervical cancer in its early stages, rarely detects ovarian cancer and usually only in its late stages.

Endometrial cancer

Each year there are about 37,400 cases of endometrial cancer in the U.S. These occur most often in the endometrium - the inside lining of the uterus. About 6,400 women die of this cancer in the U.S. every year

Who is at risk?

Endometrial cancer occurs most often in women over the age of 50. Estrogen replacement therapy and tamoxifen increase a woman's risk of this disease.

Other risk factors include the early onset of menstrual periods, late menopause, a history of infertility, never having had children, obesity, diabetes, and high blood pressure. Pregnancy and the use of oral contraceptives appear to provide some protection against this type of cancer.

Best defense: early detection

Watch for signs and symptoms, such as abnormal bleeding from the uterus. During menopause, women at high risk should have a tissue sample or biopsy taken from the endometrium for evaluation.

Although the Pap test is very good at detecting cancer of the cervix (the part of the uterus that extends into the upper vagina), it is not a reliable test for the early diagnosis of endometrial cancer.

Prevention or early detection is the best defense

Early detection -- finding a cancer early before it has spread -- gives you the best chance of being treated successfully. Too many women die each year from cancer. You can reduce your risk for some cancers by adopting certain behavior, for example, stopping smoking and losing weight.

The writer, injila@hotmail.com, is a general practitioner based in Denpasar, Bali.