Guide to Wellness – July 2019

56 GUIDE TO WELLNESS CR.ORG

people with cancer that may
have spread or, in an emergency,
those with a significant injury.
POSSIBLE OUTCOMES: If the scan
finds growths or abnormalities,
you might need other tests and
treatment. These scans often
find abnormalities (an average
of three per person) that almost
always turn out to be harmless,
according to a 2013 analysis by
Air Force researchers. One-third
of people have unnecessary
follow-ups that expose them
to additional radiation.

Heart Scans

Coronary CT angiography
(CCTA) and coronary artery
calcium (CAC) scans use
multiple X-rays to image your
arteries.
WHY IT’S DONE: Both check
for plaque in arteries; a CCTA
scan also looks for structural
abnormalities.
RECOMMENDED FOR: Those with
symptoms such as shortness
of breath and chest pain (the
CCTA), and those at risk of
heart disease (the CAC). The
Society of Cardiovascular
Computed Tomography
advises against both for most
other people.
POSSIBLE OUTCOMES: A CAC
scan may help people at risk
decide, with their doctor, how
aggressively to treat their
condition. For those with
symptoms, either screening
may be used with other tests
to diagnose heart disease.
For those at low risk, the tests
expose them to radiation
unnecessarily and could lead
to unneeded procedures.

Mammograms

and Other Breast

Cancer Screenings

With a mammogram, your
breast is compressed between
two plates and an X-ray is
taken. An increasing number
of facilities use multiple X-rays
to create a 3D image (called
digital breast tomosynthesis).

Also available are magnetic

resonance imaging (MRI),

which uses strong magnets

and radio waves to create a

detailed image of the breast,

and ultrasound imaging.

WHY IT’S DONE: To detec t

breast cancer early, when it

may be more treatable.

RECOMMENDED FOR: Major

medical organizations agree

that women should be

offered the option to have

a screening mammogram

at age 40. The ACS advises

women to start at age 45,

the USPSTF recommends

age 50, and the American

College of Obstetricians and

Gynecologists says no later

than 50. Recommendations on

frequency vary from one to

two years. Studies suggest

that 3D tests may detect

slightly more cancers than

standard mammograms but

haven’t shown yet that they

save more lives. Ultrasound

imaging and an MRI can find

cancers that a mammogram

can miss but also pick up

harmless abnormalities. These

tests aren’t thought to be

beneficial on their own but

are useful in conjunction with

mammograms for women at

high risk.

POSSIBLE OUTCOMES: These

screenings may detect

invasive breast cancers before

they spread, sparing women

more extensive treatment and

possibly saving lives. But all

can result in false positives,

leading to unwarranted

follow-up imaging and

biopsies. The tests can also

miss some cancers, so it’s

important to talk with your

doctor about your health

history and risk factors,

and what type of screening

is best for you. There’s

insufficient evidence about

the effectiveness of screening

after age 75.

Mouth and Neck

Cancer Screening

Healthcare providers perform a

physical and visual examination

that may include the face, neck,

nose, mouth, and throat as part

of a routine exam.

WHY IT’S DONE: To check for

cancers and precancers.

RECOMMENDED FOR: Hospitals and

clinics routinely host free public

screening, but major medical

organizations such as the

USPSTF, ACS, and the American

Dental Association (ADA) don’t

recommend the screening for

healthy people. “There’s no

clinical study showing that the

exam saves lives,” says Otis

Brawley, M.D. The ADA does

advise dentists to be alert for

abnormalities during dental

exams, especially in people who

smoke or drink, because those

habits hike cancer risks.

POSSIBLE OUTCOMES: If anything

suspicious is found, a doctor

will do a biopsy and remove

the lesion if it’s cancerous. Most

growths found are harmless,

so the exam could lead to a

false positive and unnecessary

biopsies and treatment.

Pap and HPV (Cervical

Cancer) Tests

In a Pap test (or Pap smear) and

an HPV test, your doctor

removes cells from your cervix

and examines them.

WHY IT’S DONE: The Pap looks

for precancerous changes

in cervical cells; the HPV

looks for the types of human

papillomavirus that cause cell

changes. Both may indicate

a cervical cancer risk.

RECOMMENDED FOR: Women

ages 21 to 29 should have a Pap

every three years, according

to the USPSTF, ACS, and other

organizations. Those 30 to 65

can follow that schedule or

lengthen the time to five years

if they get an HPV test at the

same time. After several normal

results, you can stop screening

at age 65. Women who’ve had

a hysterectomy that included

Lung

Cancer

Scan

This low-dose CT

scan images the

lungs.

WHY IT’S DONE

It has been found to

detect lung cancer

early and prevent

death among those

at highest risk.

RECOMMENDED

FOR

Adults 55 to 80 with a

“30 pack-year” history

(smoking a pack of

cigarettes daily for

30 years or two packs

for 15 years) who

currently smoke or

quit within the past

15 years should be

screened yearly, says

the U.S. Preventive

Services Task Force.

But fewer than

2 percent of them are

tested, the American

Society of Clinical

Oncology notes.

POSSIBLE

OUTCOMES

If anything suspicious

is found, additional

screening or a lung

biopsy may be

necessary. Note: This

screening has a very

high rate of false

positives. According

to a 2013 USPSTF

analysis, for every

lung cancer death the

scan prevents, 302

people without the

disease test positive.

Medical Tests

56 GUIDE TO WELLNESS CR.ORG