[Fat Bear Science] The Physical Examination Center summarizes 10 questions about tumor screening. Are there any that you are concerned about?

It’s the end of the year again

How is your medical examination report?

Physical examination is the most direct way to detect diseases

For cancer screening

The importance of physical examination is self-evident.

During the physical examination

There are usually many projects for you to choose from.

What are cancer screenings?

The most direct and economical way?

Which groups of people are at high risk of cancer?

Is a routine physical examination a cancer screening?

Some people also asked

The annual physical examination indicators are normal

How come it’s already in the late stage of cancer when it’s discovered?

......

The Physical Examination Center of the Affiliated Cancer Hospital of Chongqing University has summarized 10 questions. See if there are any that you are concerned about?

Text丨Fat Bear

Expert丨Zhang Haiyan丨Xin Yu

Audit丨Health Checkup and Cancer Screening Center

What is cancer screening?

Is a health check-up the same as cancer screening?

Health check-up ≠ tumor screening. The scope of general health check-up cannot fully cover the scope of tumor screening, and the focus is mainly on physical examination, cardiovascular and cerebrovascular diseases, diabetes and other chronic diseases. However, tumor screening covers general physical examinations. Professional tumor screening can screen out high-risk groups based on pre-examination risk assessment, and make corresponding prevention and treatment measures according to different examination results, including regular monitoring and follow-up visits, chemical prevention, surgical preventive resection, etc., to eliminate the occurrence and development of malignant tumors in the bud as much as possible to achieve the best treatment effect. In addition to the early detection of tumors in the body, anti-cancer physical examinations will also analyze the factors that may cause the examinee to develop tumors in the future, and provide health education and unhealthy lifestyle intervention to the examinee.

Why wasn't cancer screening chosen?

Wrong item selected

In most physical examination packages, color Doppler ultrasound is generally performed, but chemical tumor markers that can reflect the presence of tumors are not "must-haves". For example, routine liver examinations only include liver function and abdominal color Doppler ultrasound, but for liver cancer screening we will also choose AFP, AFP-L3, and DCP combined testing, which is very meaningful for the diagnosis of liver cancer, and further combine it with CT, MRI and other examinations when necessary.

Some screening tests are not easy to accept

During routine examinations, gastrointestinal tumor screening is not easily accepted by the public. Many people are afraid of pain, dare not check, and it is inconvenient, so it has become a neglected item, resulting in missing the golden time for discovering precancerous lesions.

No targeted testing for high-risk groups

During the physical examination, if the female examinee has a family history of breast cancer or chronic breast disease, the chance of developing breast cancer is high, and she will be recommended to undergo a combined breast mammography and breast color ultrasound examination.

Cognitive biases are easy to ignore

At present, the incidence of lung cancer in women is increasing year by year. Often, female examinees will ignore the early screening of lung cancer and just choose chest X-ray examination as a routine. As a result, some early lesions will be missed. Therefore, for people at high risk of lung cancer, we will recommend low-dose spiral CT of the chest and focus on the management of the lung nodules that have been screened out.

The incidence of lung cancer in women is increasing year by year

Do only people at high risk of cancer need physical examinations?

Who is at high risk of cancer?

People with a family history of malignant tumors (usually including a history of malignant tumors in direct or collateral relatives within three generations);

People who have bad living habits such as long-term heavy smoking, long-term alcoholism, drug abuse, etc.

People who are exposed to toxic and hazardous substances for a long time due to occupational reasons;

People living in polluted environments (chemical pollution, heavy metal pollution, etc.);

People who are infected with special microorganisms (hepatitis B virus, HIV, etc.).

The above are people at high risk of cancer, but not only people at high risk need physical examinations.

Is the physical exam the same for every age?

Different age groups focus on screening different tumors. Age is also an important reference factor for tumor screening, because the incidence of various tumors is different in people of different age groups. Tumor screening should be carried out in a targeted manner based on one's own physical condition and combined with factors such as age.

Can lung cancer be detected with a chest X-ray?

Chest X-rays can only be used as an initial screening for lung tumors. It is inaccurate to rely solely on X-rays for diagnosis. Patients with positive initial screening results must undergo a chest CT scan. If a chest X-ray diagnoses lung cancer, the clinical condition has already reached an advanced stage. The currently commonly used low-dose spiral CT screening can detect small nodules of 0.1-0.5 cm and can accurately display the subtle structure and edge characteristics of small nodules in the lungs.

It is inaccurate to make a diagnosis based on X-ray examination alone.

Are the more physical examination items the better?

Some tumor screening items have potential pathogenic risks to the human body, which requires oncology doctors to weigh and make choices based on the specific circumstances of the examinees. It is not the case that the more items the better, but the more accurate the selection of items the better.

Is it necessary to do tumor screening if there are no related symptoms?

In my country, the incidence of gastrointestinal cancer is relatively high. However, most units and individuals have not included gastroscopy and colonoscopy in the physical examination items. Because the operation of gastroscopy and colonoscopy will make people feel a little uncomfortable, it scares away many people who undergo physical examinations. Some people are lucky and think that they will not suffer from gastrointestinal tumors if they have no symptoms. Therefore, people who agree to do gastrointestinal endoscopy almost all have symptoms such as diarrhea, abdominal pain, and blood in the stool. There are almost no people who actively request the above examination items. In fact, early colorectal cancer often has no clinical symptoms. Sometimes when symptoms such as chronic diarrhea, abdominal pain and weight loss occur, they are often treated as ordinary diarrhea, which delays early diagnosis and treatment.

In my country, the incidence of gastrointestinal cancer is high, and early colorectal cancer often has no clinical symptoms.

Cancer screening is for the elderly.

Young people don’t have to do it?

Many tumors are getting younger, so screening is not just for the elderly. At the same time, it is not necessary to check for tumors as you age. Because prostate cancer in the elderly progresses very slowly, most cases are not life-threatening, so there is no need to conduct annual prostate cancer screening after the age of 75.

Normal tumor markers = no cancer?

Most people who have physical examinations over the age of 40 will choose to test tumor markers. Most of them believe that tumor markers can directly detect tumors, and if the test results of tumor markers are within the normal range, it means that there is no tumor in the body. However, as everyone knows, various tumor markers in clinical practice can only be used as one of the auxiliary diagnostic indicators of tumors, and clinical diagnosis cannot be determined solely by the test results of tumor markers. Indeed, for many tumors, especially when cancer occurs, the test results of tumor markers may be significantly higher than normal, such as: prostate cancer and PSA, liver cancer and AFP, etc. These are highly specific cancer indicators, which can reflect the presence of cancer to a certain extent, but for some cancers with low specificity, such as: lung cancer, gastric cancer, intestinal tumors, etc., often when the tumor marker test results show normal, it is possible that cancer has already occurred.

Stay away from cancer, in addition to regular physical examinations,

What else should we pay attention to in our daily life?

Maintain a healthy weight and avoid weight gain in adulthood;

Make physical activity a part of your daily routine, walking more and sitting less;

Consume a dietary pattern rich in whole grains, vegetables, fruits, and legumes;

Limit the intake of "Western fast food" and other processed foods high in sugar and fat;

Don’t eat too much red meat, and try not to eat processed meat;

Limit your intake of sugary drinks, and drink water or sugar-free drinks in most cases;

Limit alcohol intake. From a cancer prevention perspective, it is best not to drink at all.

Do not take dietary supplements to prevent cancer. For most people, a balanced diet and adequate exercise are the best ways to prevent cancer.

For breastfeeding women: If you can, breastfeed your baby, which has a protective effect against breast cancer;

Annual regular physical examinations should not be missed, and specific groups of people should be screened for high-risk factors. Early screening and early detection can lead to early treatment.

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Zhang Haiyan

Director of the Health Examination and Tumor Screening Center of the Affiliated Tumor Hospital of Chongqing University.

He is good at risk assessment of various chronic diseases and tumors, formulation of various screening programs, disease and health management, and popular science publicity.

Clinic Hours:

Monday to Friday, 8:00am-12:00pm

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Xin Yu

Nurse at the Health Examination and Tumor Screening Center of the Affiliated Tumor Hospital of Chongqing University.

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