Women aged 50 and older should be screened for breast cancer by mammography and clinical breast examination every 1 to 2 years. There is no clear evidence for benefit of screening in women younger than age 50. Women with a strong family history of breast cancer or breast and ovarian cancer should receive extensive counseling before making a decision about screening for mutations in BRCA1. There are no studies to guide recommendations for screening or prophylaxis for those women who choose screening and who carry a mutation. Screening for ovarian cancer by any modality for women of average risk is not recommended. Primary care providers should counsel women with a family history of ovarian cancer. Some women may benefit from genetic counseling and testing. Screening of high-risk women must be individualized between the provider and the patient, with the understanding that no screening modality has been shown to reduce mortality from this disease. Endometrial sampling is not useful in screening for endometrial cancer in an asymptomatic population. Endometrial sampling and the use of transvaginal ultrasound should be reserved for women with abnormal vaginal bleeding. Cervical cytology is an effective measure for cervical cancer prevention. Screening should begin at the onset of sexual activity and should be continued at least every 3 years up to age 65. Based on current studies, adjunctive tests such as HPV typing, cervicography, and Papnet are not useful screening tools and they are not recommended. Table 2 summarizes the incidence, risk factors, and US Preventive Services Task Force screening recommendations for the cancers discussed in this article.
|Original language||English (US)|
|Number of pages||12|
|Journal||Primary Care - Clinics in Office Practice|
|State||Published - 1997|
ASJC Scopus subject areas