# Cancer: should one get scanned yearly? **URL:** \ **Category:** Factual Questions\ **Created:** [August 27, 2003, 6:01pm UTC](https://boards.straightdope.com/t/cancer-should-one-get-scanned-yearly/198028 "2003-08-27T18:01:25Z")\ **Posts on this page:** 10\ **Page:** 1
**Author:** ![Phlosphr](https://avatars.discourse-cdn.com/v4/letter/p/c68b51/32.png) [@Phlosphr](https://boards.straightdope.com/u/Phlosphr)\ **Post date:** [August 27, 2003, 6:01pm UTC](https://boards.straightdope.com/t/cancer-should-one-get-scanned-yearly/198028/1 "2003-08-27T18:01:25Z")
I raise this question as a good friend is going through a horrible cancer right now. Stage three non-hodgekins Lymphoma. She’s been to chemo 5 times and just found out she needs more. She had looked like a very healthy person, active, 31, this really came out of left field. Is there a time frame that one should follow for getting some sort of scan? What scan would it be? Is it practical? What age should one start at? ---
**Author:** ![Qburn](https://avatars.discourse-cdn.com/v4/letter/q/bc79bd/32.png) [@Qburn](https://boards.straightdope.com/u/Qburn)\ **Post date:** [August 27, 2003, 7:02pm UTC](https://boards.straightdope.com/t/cancer-should-one-get-scanned-yearly/198028/2 "2003-08-27T19:02:19Z")
Depends on a persons age, family history & type of cancer. I did a quick search, here are some guidelines for certain types. [http://www.aafp.org/afp/20010315/1101.html](http://www.aafp.org/afp/20010315/1101.html) ---
**Author:** ![MsRobyn](https://avatars.discourse-cdn.com/v4/letter/m/90ced4/32.png) [@MsRobyn](https://boards.straightdope.com/u/MsRobyn)\ **Post date:** [August 27, 2003, 7:16pm UTC](https://boards.straightdope.com/t/cancer-should-one-get-scanned-yearly/198028/3 "2003-08-27T19:16:08Z")
There are imaging scans available for lymphoma, but they’re not done on a routine, screening basis. For one thing, they’re too expensive to justify insurance coverage, and all but the most paranoid (or wealthy) can afford to pay cash for them. So, there’s that part. FTR, CTs and plain x-rays are used to follow a patient with the disease. The CTs can run several hundred dollars per site, and even a plain chest X-ray can cost over $100 between hospital and radiologist fees. Most insurance companies will not cover these tests with anything but an active disease code; screening is not acceptable for reimbursement. According to [this site](http://www.leukemia-lymphoma.org/all_page?item_id=8965), you probably don’t have a lot to worry about, statistically speaking. Lymphoma generally doesn’t occur until middle to old age. Even so, you’ll have symptoms that will clue your doctor to look for it. This is just for lymphoma. Other cancers should be screened for; breast, colon, prostate, cervical cancers are routinely screened for, and should be. See your doctor for more information on these tests. Robin ---
**Author:** ![j.c](https://avatars.discourse-cdn.com/v4/letter/j/73ab20/32.png) [@j.c](https://boards.straightdope.com/u/j.c)\ **Post date:** [August 27, 2003, 10:15pm UTC](https://boards.straightdope.com/t/cancer-should-one-get-scanned-yearly/198028/4 "2003-08-27T22:15:49Z")
Are you asking about seeking tests for lymphoma? Or hopping into a tube for an all-purpose all-body scan. If I understand correctly, this amazing new all-purpose all-body, all-system with minty freshness scan is not as valuable as the vain and wealthy hope. Isn’t the current thinking that having annual scans is likely to cause needless stress? That only people who have a suspect genetic history should use this technology? MDs, could y’all weigh in? ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [August 27, 2003, 11:13pm UTC](https://boards.straightdope.com/t/cancer-should-one-get-scanned-yearly/198028/5 "2003-08-27T23:13:01Z")
Only in a few instances have screening procedures for asymptomatic patients without risk factors been found to be of benefit; Breast cancer, cervical cancer, colon cancer, and prostate cancer (but only in select ethnicities). Even in these instances, the means to screen remain controversial. It still has not been shown that annual fecal blood testing is any less effective in detecting cancer than a sigmoidoscopy every 5 years. here’s a nice PDF file on what the consensus is in this country about what conditions should be screened for. [http://www.ahcpr.gov/ppip/adulttm.pdf](http://www.ahcpr.gov/ppip/adulttm.pdf) there’s a lot more info here: [http://www.ahcpr.gov/clinic/ppipix.htm](http://www.ahcpr.gov/clinic/ppipix.htm) Anecdotally, screening is a wonderful idea, but it often fails in practice. Consider ovarian cancer, which generally is too far advanced to cure by the time it causes symptoms. One great test which does pick up ovarian cancer before it causes symptoms and it’s too late to cure is _pelvic ultrasound_. So one immediately thinks: “Let’s screen all women for ovarian cancer with pelvic ultrasound”. A fine idea, as the test picks up nearly all cases of early ovarian cancer. But it also picks up a **lot** of “false positives” or things that look like ovarian cancer on the ultrasound, but aren’t. And what must be done with an ultrasound which shows something that may be ovarian cancer? Surgery! Laparoscopic surgery, specifically. Which while safe overall, has its complications. In fact, for every case of ovarian cancer that an ultrasound will pick up early enough to cure, there will be over 20,000 normal ultrasounds performed which otherwise would not have been done, and 1500 unnecessary surgical procedures without complications done on women with abnormal ultrasounds without the disease. There will also be 150 _complications_ from the laparoscopic surgery on women who had an abnormal ultrasound, but no disease. The complications for the most part will be minor, but some will be major, and some women will die from it. So in the case of ovarian cancer, the proposed screening protocol would be vastly expensive, tie up lots of resources, and cause more harm than benefit. Thus far, few screening tests have stood up to the gold standard for implementation: Does it accurately test for the disease, while accurately excluding people who don’t have the disease? Does it find the disease early enough to make a difference in outcome? And can we as a society afford to do this sort of screening? ---
**Author:** ![BobT](https://avatars.discourse-cdn.com/v4/letter/b/8e8cbc/32.png) [@BobT](https://boards.straightdope.com/u/BobT)\ **Post date:** [August 27, 2003, 11:21pm UTC](https://boards.straightdope.com/t/cancer-should-one-get-scanned-yearly/198028/6 "2003-08-27T23:21:50Z")
And for men, you can perform your own exams for testicular cancer. And that’s got to be one of the easiest forms of cancer to detect on your own. ---
**Author:** ![TheFunkySpaceCowboy](https://avatars.discourse-cdn.com/v4/letter/t/a9a28c/32.png) [@TheFunkySpaceCowboy](https://boards.straightdope.com/u/TheFunkySpaceCowboy)\ **Post date:** [August 28, 2003, 4:49am UTC](https://boards.straightdope.com/t/cancer-should-one-get-scanned-yearly/198028/7 "2003-08-28T04:49:09Z")
Also don’t forget that most of the diagnostic scanning you’re thinking of does expose you to fair bit of radiation. A CT scan is just a whole bunch of tiny x-rays and to use a PET scanner or a gamma camera you have to be injected with radioactive material. For a single scan these doses aren’t anywhere near high enough to be harmful, but they still aren’t something you want to be exposing yourself to on a regular basis if you don’t have a reason to. ---
**Author:** ![js\_africanus](https://avatars.discourse-cdn.com/v4/letter/j/87869e/32.png) [@js\_africanus](https://boards.straightdope.com/u/js_africanus)\ **Post date:** [August 28, 2003, 12:38pm UTC](https://boards.straightdope.com/t/cancer-should-one-get-scanned-yearly/198028/8 "2003-08-28T12:38:51Z")
> [@](#): > > \*Originally posted by Phlosphr \* > \*\*Is it practical? What age should one start at? \*\* If you do the math, a lot of regular screening sans symptoms will most likely give you false positives, which are very stressful, psychologically taxing, potentially dangerous, and can leave you very shaken for years to come. Google for “Bayes’ rule”. I would strongly advise reading Gerd Gigerenzer’s book _Calculated Risks_. I’m a cancer survivor, so don’t think that I don’t take it seriously. ---
**Author:** ![Phlosphr](https://avatars.discourse-cdn.com/v4/letter/p/c68b51/32.png) [@Phlosphr](https://boards.straightdope.com/u/Phlosphr)\ **Post date:** [August 28, 2003, 1:24pm UTC](https://boards.straightdope.com/t/cancer-should-one-get-scanned-yearly/198028/9 "2003-08-28T13:24:22Z")
Thank you all for the information. **Q** - thanks for being especially informative. The woman in the OP is a friend who has had a large genetic history of Cancer. My family, and my wifes family have very little instance of fatal cancer in our family. I am hyperaware of cancer, yet I do not swell on it. I don’t want the psychological tax. My lifestyle is such that I do not ahve a lot of risk factors. I used to smoke but that was only in college. I haven’t in years. I drink a fair bit but wine and spirits is certainly not out of control. If I wanted the scans I’d get them. I do get checked for colon cancer on a yearly basis - I don’t think anyone likes that procedure - but I am only 34 (nearly)…Thanks again all. And thanks for the link **Robin**. ---
**Author:** ![Eva\_Luna](https://avatars.discourse-cdn.com/v4/letter/e/e495f1/32.png) [@Eva\_Luna](https://boards.straightdope.com/u/Eva_Luna)\ **Post date:** [August 28, 2003, 2:49pm UTC](https://boards.straightdope.com/t/cancer-should-one-get-scanned-yearly/198028/10 "2003-08-28T14:49:03Z")
I cannot emphasize enough the importance of rgular Pap smears for women. One may very well have saved my fertility, if not my life, last year. Caught cervical cancer just before it was about to go ballistic and become invasive. Approximate 5-year survival rate for noninvasive cervical cancer: 99%. For invasive cervical cancer: 7%. I had no known risk factors. I go for an exam every year without fail, and all were completely clean until the last one. I’m 34 years old and otherwise a basically healthy nonsmoker. Just Do It!