Why do many people have annual physical examinations but cannot detect early-stage cancer?

This article was reviewed by Dr. Guo Xiaoqiang, a popular science writer in the field of life sciences

Data released by the National Cancer Center, the 2017 China Cancer Registry Annual Report, shows that in China, there are 4.29 million new cancer cases each year, accounting for 20% of new cases worldwide, and 2.81 million deaths. In other words, about 10,000 people are diagnosed with cancer every day in the country.

If a person lives to 85 years old, his risk of cancer is 36%;

For most people, the incidence of cancer increases rapidly after the age of 40, reaching a peak at the age of 80; lung cancer has the highest incidence and mortality rates; thyroid cancer is rising rapidly; the cancers with the highest mortality rates are mainly lung cancer and digestive system cancers.

Why many Chinese are "pretending to prevent cancer"

The first is the problem of technical limitations.

The second issue is the level of technical skills.

For example, taking lung cancer, which has the highest mortality rate, as an example, in reality, many areas in my country still use X-rays to detect lung cancer.

You should know that the probability of detecting early lung cancer with X-rays is only 0% to 15%, which is very low. Usually, lung cancer found by X-rays is basically in the middle and late stages. This is because 43% of the lung area overlaps with tissues such as the heart and mediastinum, and early lung cancer can easily be treated as chronic inflammation.

For many people, they just take a positive film and leave. This is why many office workers have annual physical examinations at their companies, but still cannot find cancer. Therefore, although many medical experts are now calling for scientific cancer prevention, after so many years, many Chinese people are still pretending to take preventive measures.

8 Common Cancer Screenings Everyone Should Know

There are many studies on cancer screening around the world, some of which have reached a broad consensus and have corresponding screening guidelines or expert consensus.

Cancer screening is a more professional and targeted physical examination method. Who should do it, what items should be done, and how to do it are all very particular, which is also the fundamental difference between it and general health examinations.

1. Lung cancer screening: Remember to use CT

X-rays have a low detection rate for lung cancer due to their low resolution. If a chest X-ray diagnoses lung cancer, it is often already in the late stage of the disease. It can be said that using X-rays to detect lung cancer is simply a pretense of cancer prevention.

Experts recommend: High-definition CT scans for lung cancer can detect lung cancer tumors at 1 cm or even 0.8 cm due to their high resolution. It is recommended that middle-aged and elderly people over 50 years old or those with a family history of lung cancer replace X-rays with CT scans during physical examinations. In addition, it is recommended that low-dose spiral CT scans be used to detect lung cancer. With the addition of several biomarkers, the detection rate can reach over 90%.

2. Breast cancer screening: Remember to use mammography

Some people think that CT is omnipotent, but it is not. When CT is used for breast cancer detection, it has the disadvantages of low sensitivity and low specificity for breast. In addition, some places use infrared to detect breast conditions, which is also not recommended because infrared detection is not based on international standards, the machine has poor performance, low sensitivity, large errors, and the doctor's subjective judgment is strong. Nowadays, large hospitals do not use this method for detection.

Experts recommend: For early screening of breast cancer, it is recommended to first use mammography. Compared with breast CT, MRI examination is significantly better.

3. Cervical cancer screening: Remember to use TCT

When many people think of cervical cancer screening, the first thing they think of is HPV screening. In fact, HPV is a test for the cause of the disease. The truly effective test for cervical cancer is the TCT test.

Experts suggest: TCT, or liquid-based thin-layer cell testing, has significantly improved specimen satisfaction and the detection rate of abnormal cervical cells compared to traditional cervical scraping and Pap smear examinations, and is now widely used in clinical practice. TCT cervical cancer screening can detect more than 90% of cervical cancer cells, and can also detect precancerous lesions and microbial infections such as mold, Trichomonas, and Chlamydia.

4. Prostate cancer screening: Remember to do PSA screening

In addition to the abdominal color Doppler ultrasound that everyone is familiar with, experts point out that abdominal color Doppler ultrasound cannot detect early prostate cancer at all, and it is not even useful for diagnosis. The best test for screening prostate cancer is PSA prostate-specific antigen!

Experts recommend that men over 50 years old use the prostate-specific antigen (PSA) test to screen for prostate cancer. PSA is cheaper and is the most convenient and sensitive method for early screening of prostate cancer.

5. Esophageal cancer screening: Remember to do an endoscopic examination

When it comes to esophageal cancer, many people don't know what tests to do. The best way is to do an endoscopy.

Experts recommend that people at high risk of esophageal cancer should first undergo conventional endoscopic examinations, and concurrent examinations such as iodine staining of the esophageal mucosa or electronic staining endoscopy. If no suspicious lesions are found under endoscopy, regular follow-up is performed; if suspicious lesions are found under endoscopy, a biopsy pathology is performed, and corresponding follow-up review and treatment plans are taken according to different pathological results. For example, it is recommended to follow up once every 3 years for mild dysplasia.

6. Gastric cancer screening: Remember to do a gastroscopy

The main screening method for gastric cancer is gastroscopy, and the detection rate of other methods is very low.

Experts recommend: People at high risk of gastric cancer may consider direct gastroscopy screening. If suspicious lesions are found during gastroscopy, a biopsy will be taken for pathological examination, and follow-up and treatment plans will be taken according to the biopsy pathological results.

7. Colorectal cancer screening: Remember to do a colonoscopy

The most effective method for colorectal cancer screening is colonoscopy. In many physical examinations, many people are most reluctant to do colonoscopy and often ignore it.

Experts recommend: 45-75 years: fecal immunochemical test (yearly); or high-sensitivity guaiac fecal occult blood test (yearly); or multi-target fecal DNA test (every 3 years); colonoscopy (every 10 years); or CT colonography (every 5 years); or flexible sigmoidoscopy (every 5 years). All positive results of non-colonoscopic screening tests should be promptly followed by colonoscopy. Adults who are in good health and have a life expectancy of more than 10 years should continue screening until age 75.

8. Liver cancer screening: remember alpha-fetoprotein + B-ultrasound

Many people choose to do abdominal B-ultrasound during physical examinations, thinking that this can detect liver problems, but in fact it is easy to miss the diagnosis.

Experts recommend: High-risk groups (those infected with hepatitis B virus and/or hepatitis C virus, those who have long-term alcoholism, non-alcoholic fatty hepatitis, those who have eaten food contaminated with aflatoxin, those with cirrhosis caused by various reasons, and those with a family history of liver cancer, etc.) aged 40 and above are recommended to consider screening every six months. Most domestic experts recommend regular screening of high-risk groups for liver cancer by combining alpha-fetoprotein testing and liver ultrasound examinations. If abnormalities are found, further consideration should be given to CT or MRI examinations.

Finally, remember these methods,

Don’t ever “pretend to check for cancer” again!

Source: Health Times (ID: jksb2013)