Taking care of women's health is an integral part of overall human well-being. A significant aspect of health care is regular medical screening, which helps detect diseases at early stages when they are more easily treatable. In this article, we will discuss the specifics of screening for breast, cervical, ovarian, and endometrial cancers, as well as recommendations for women of different age groups and risk levels.
Breasts
Mammography is the key screening procedure for detecting breast cancer. Risk assessment is done using specialized calculators that consider factors such as age and family history. Different approaches are recommended for average-risk and moderate-risk individuals:
- Under 40 years old: Mammography screening is not recommended
- 40-74 years old: Mammography is recommended every 1-2 years
- Over 75 years old: Mammography every 2 years if life expectancy is more than 10 years Self-palpation of the breasts or the use of ultrasound (US) and magnetic resonance imaging (MRI) as screening methods is not recommended. There is no definitive consensus on breast self-examination because it is highly subjective; therefore, self-examination is not considered a screening method. Women at high risk, such as carriers of BRCA gene mutations, may undergo more frequent screening and, if necessary, preventive mastectomy
Cervix
Cervical cancer screening includes taking a Pap smear (also called cervical cytology or cervical cytological examination) and/or testing for HPV (human papillomavirus). Recommendations based on age groups are as follows:
- 21-65 years old: Pap smear every 3 years (if results are normal) and HPV testing every 3-5 years
- Over 65 years old: Screening may be discontinued with normal results, two negative HPV tests, or Pap+HPV tests over a 10-year period, or three negative Pap smears over a 10-year period
Ovaries
Routine screenings are not recommended as they lead to an increase in the number of surgical interventions. Screening for ovarian cancer is only recommended for women at high risk, such as those with relatives who have had ovarian cancer or carriers of BRCA genetic mutations. Between ages 35-40, consideration may be given to the removal of the ovaries and fallopian tubes (salpingo-oophorectomy) to reduce the risk.
Endometrium
Endometrial cancer screening is primarily carried out in women with Lynch syndrome, which is a genetic disorder: it is recommended to perform a pipelle biopsy starting at age 30-35 and possibly consider a hysterectomy at ages 35-40. If there are risk factors (late menopause, no history of childbirth, diabetes, hypertension, history of hormone replacement therapy, treatment with tamoxifen), routine screenings are not performed, but if there is abnormal uterine bleeding or spotting, a pipelle biopsy and, in some cases, hysteroscopy with curettage is required.