Can Routine Health Checkups Detect Cancer? What You Need to Know

Q: Can Routine Health Checkups Detect Cancer? What You Need to Know

Hello, Ms. Jean： A) Unless there are obvious symptoms, routine health check-ups generally cannot detect cancer. B) Common examinations for tumors include： - Esophageal tumors： upper gastrointestinal series, esophagogastroduodenoscopy (EGD), computed tomography

Health check-up

Can a routine health check detect cancer, or is it necessary to undergo additional specialized tests that require out-of-pocket expenses? Regarding these specialized tests, how can we determine which type of cancer requires which specific examination for detection?

jean, 10~19 year old female. Ask Date: 2002/02/22

Dr. Fang Sijie reply Family Medicine

Hello, Ms.
Jean:
A) Unless there are obvious symptoms, routine health check-ups generally cannot detect cancer.

B) Common examinations for tumors include:
- Esophageal tumors: upper gastrointestinal series, esophagogastroduodenoscopy (EGD), computed tomography (CT) scan, etc.
- Gastric tumors: upper gastrointestinal series, EGD, CT scan, etc.
- Pancreatic tumors: ultrasound, CT scan, etc.
- Liver tumors: ultrasound, CT scan, etc.
- Gallbladder and biliary tumors: ultrasound, CT scan, percutaneous transhepatic cholangiography (PTC), endoscopic retrograde cholangiopancreatography (ERCP), etc.
- Colorectal tumors: colonoscopy, sigmoidoscopy, fecal occult blood test, etc.
- Renal tumors: ultrasound, CT scan, intravenous pyelography (IVP), etc.
- Pulmonary tumors: chest CT scan, etc.
- Breast tumors: mammography, etc.
C) There are also tumor marker blood tests available for screening high-risk groups for cancer.
Tumor markers are substances or antigens secreted by certain tumor tissues or pathological substances caused by cancer cells, which can be extracted from peripheral blood and measured using precise biochemical methods or immunoassays (such as enzyme-linked immunosorbent assay).
Clinically, the goal is to detect cancer early for treatment.
Tumor markers do not specifically indicate one type of cancer but are associated with multiple pathological factors, leading to various cancers being related to a single tumor marker.
Some commonly used tumor markers include:
- CEA: colorectal cancer, pancreatic cancer.
- AFP: hepatitis, ovarian cancer, testicular cancer, teratoma.
- β-HCG: choriocarcinoma, ovarian cancer, testicular cancer.
- Osteocalcin: bone cancer, gastrointestinal cancers.
- Acid phosphatase: prostate cancer.
- Alkaline phosphatase: liver cancer.
- Ectopic TSH: liver cancer, breast cancer.
- Ectopic PTH: lung cancer, ovarian cancer, pancreatic cancer, kidney cancer.
- T cell marker: lymphosarcoma.
- Estrogen receptor: breast cancer.
- Progesterone receptor: breast cancer.
- CA-125: ovarian cancer.
- CA 19-9: pancreatic cancer, colorectal cancer.
- CA 72-4: pancreatic cancer, colorectal cancer.
- CA 195: pancreatic cancer, colorectal cancer.
- CA 15-3: breast cancer.
- CA 549: breast cancer.
- Anti-EBV VCA IgA: nasopharyngeal carcinoma.
- HPV DNA: cervical cancer.
- HBV DNA: liver cancer.
- PSA: prostate cancer.
D) For men over 50 with a long history of smoking and alcohol consumption, and with a family history of esophageal or gastric cancer, it is recommended to undergo endoscopic examination as a primary strategy.
E) Testing for fecal occult blood is a preliminary method for screening colorectal cancer, but early colorectal cancer may not always present with bleeding, so multiple tests are necessary.
If there are still concerns, a colonoscopy should be performed after bowel preparation for further investigation.
F) Women over 30 should ideally have a Pap smear annually, and if there are any abnormalities, they should follow their physician's recommendations for further evaluation.
G) Women over 50 who experience occasional abnormal vaginal bleeding after menopause, are not pregnant, or have irregular menstruation should be cautious of the risk of uterine cancer.
H) It is important to perform monthly breast self-examinations, and if there are any abnormal lumps or unexplained nipple discharge, medical attention should be sought immediately.

Reply Date: 2002/02/22

More Info

Routine health checkups play a crucial role in maintaining overall health, but they are generally not designed to specifically detect cancer unless there are clear symptoms or risk factors present. Most standard health screenings focus on general health indicators such as blood pressure, cholesterol levels, and blood sugar levels, which do not directly indicate the presence of cancer.

To effectively detect cancer, specialized screenings and tests are often required. These tests can vary depending on the type of cancer being screened for and the individual's risk factors, including age, family history, lifestyle choices, and previous health conditions. For example, certain cancers have established screening protocols:
1. Breast Cancer: Women are typically advised to undergo mammograms starting at age 40 or earlier if they have a family history of breast cancer. Self-exams and clinical breast exams are also recommended.

2. Cervical Cancer: Women should begin Pap smear tests at age 21 and continue every three years until age 29. From ages 30 to 65, they can opt for a Pap test combined with HPV testing every five years.

3. Colorectal Cancer: Starting at age 45, individuals should have regular screenings through colonoscopies or stool tests to detect any abnormalities or cancerous growths.

4. Prostate Cancer: Men over 50, or younger if they have risk factors, should discuss PSA (Prostate-Specific Antigen) testing with their healthcare provider.

5. Lung Cancer: For individuals aged 50 to 80 with a significant smoking history, low-dose CT scans may be recommended.

In addition to these screenings, there are tumor markers that can be tested through blood samples. These markers are substances produced by cancer cells or by the body in response to cancer. However, it's important to note that tumor markers are not definitive for cancer diagnosis; they can be elevated in non-cancerous conditions as well. Common tumor markers include:
- CEA (Carcinoembryonic Antigen): Associated with colorectal and pancreatic cancers.

- AFP (Alpha-fetoprotein): Linked to liver cancer and germ cell tumors.

- CA-125: Often elevated in ovarian cancer.

For individuals with a family history of cancer, such as a parent or grandparent who had cancer, it is advisable to consult with a healthcare provider about personalized screening strategies. Genetic counseling may also be beneficial to assess inherited cancer risks.

In summary, while routine health checkups are essential for general health monitoring, they are not sufficient for cancer detection. Specialized screenings based on individual risk factors and symptoms are necessary. If you have concerns about cancer, it is best to discuss them with your healthcare provider, who can recommend appropriate tests and screenings tailored to your specific situation. Regular communication with your healthcare team is key to early detection and effective management of potential health issues, including cancer.

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