Why is cancer screening important?

Cancer screening is essential because if cancer is detected in its early stages, it can help reduce the severity of the disease and the mortality rate while increasing the chance of recovery. Cancer screening techniques and methods have now been developed and accepted as beneficial for those at high risk or concerned about cancer. It allows them to understand the risk and take proper care of themselves for a good quality of life and longevity.

Lung Cancer Screening

Lung cancer screening is very important because finding lung cancer in its early stages increases the chances of complete remission. Currently, there is a technology that provides clear results for lung cancer screening, called Low-Dose Computed Tomography (LDCT). This is a type of X-ray using low radiation doses with high sensitivity for detecting lung nodules from the early stage, significantly reducing lung cancer mortality. It is not recommended to use Chest X-ray or sputum tests as the primary screening method due to their low sensitivity.

For Low Dose CT Screening Lung Cancer, it can reduce lung cancer mortality by up to 20%. If you wait until symptoms appear, it is often diagnosed as stage 4 where the survival rate is less than 20%, but in the early stages, the survival chance is 90%. Therefore, regular annual lung cancer screenings should not be neglected.

Groups that should undergo screening

• People aged 50 and over
• Heavy smokers or those who have smoked regularly for a long time
• Those who quit smoking less than 15 years ago
• People with a family history of lung cancer
• Those who work outdoors or in high-risk environments for a long period, such as with PM 2.5 dust, smoke, etc.

Breast Cancer Screening

All women are at risk of breast cancer, so breast cancer screening is very important. It helps reduce the mortality rate from breast cancer, especially Digital Mammogram and Ultrasound Screening. Even if there is no risk or nobody in the family has had it, both methods should be combined for breast cancer screening.

• Digital Mammogram is a high-resolution special radiological examination technology that can clearly show calcification spots or abnormal tissues even when they are very small, helping to detect breast cancer from the early stages.
• Breast Ultrasound Cancer Screening uses high-frequency sound waves to examine the abnormalities of the breast tissue to see if it is normal tissue, cyst, or a lump. If a breast lump is found, the risk of it developing into cancer can be determined.

Groups that should undergo screening

Indications for Breast Cancer Screening

1. General women with moderate risk (no family history of breast cancer or other risk factors)
   • Age 40 and above should start screening. However, the recommended guidelines might differ for each country, for example:
     • Age 40-49: Consider based on physician’s discretion
     • Age 50-74: Recommend mammogram every 1-2 years
2. Those at high risk might start screening earlier (e.g., age 25-30) and may use more than one screening method, such as:
   • Having direct relatives with breast or ovarian cancer
   • Having BRCA1 or BRCA2 gene mutations
   • Having received chest radiation during childhood or adolescence
   • Having had breast cancer before

Methods for Breast Cancer Screening

1. Mammography is the standard and most effective method for screening, suitable for women aged 40 and above, significantly reducing breast cancer mortality.
2. Breast Ultrasound is often used together with mammograms when there is dense breast tissue or in younger women, helping determine if the lump is solid or a cyst.
3. Breast MRI is recommended for high-risk groups, such as those with BRCA gene mutations. It is not used for general screening due to its high cost and is not the primary screening method. However, knowing one’s breast characteristics to observe abnormalities is recommended.
4. Clinical Breast Exam (CBE) involves a doctor palpating the breasts annually, especially in those who have not had a mammogram.

Liver Cancer Screening

Liver cancer is more common in men than in women. Worryingly, it shows no symptoms at its early stages, and by the time the patient is aware, it is often severe and in the advanced stage. Screening for liver cancer in at-risk individuals is important so that if liver cancer is detected, treatment can be initiated before it becomes severe, increasing the chance of curing the disease. Screening should be performed every six months using one or more physician-recommended methods.

• Abdominal Ultrasound using high-frequency sound waves to detect abnormalities and masses in the liver. Doctors can diagnose liver tumors and cancer clearly.
• Blood Test for Alphafetoprotein (AFP) is a protein found in the blood, and if the level is above the limit, it may indicate a liver tumor, liver disease, or liver cancer.
• Test for Hepatitis C Virus Immunity (Anti-HCV) to assess the risk and monitor for liver cancer. Medical evidence shows that chronic hepatitis C infection is a major cause of liver cancer.

Groups that should undergo screening

1. Cirrhosis patients regardless of the cause, such as
   • Chronic hepatitis B or C
   • Chronic alcohol consumption
   • Fatty liver disease (NAFLD/NASH)
2. Chronic Hepatitis B Patients who are at risk, even if cirrhosis has not yet occurred, such as
   • Men over 40 years old
   • Women over 50 years old
   • Family history of liver cancer
   • High HBV DNA levels or persistent abnormal ALT levels
3. Chronic Hepatitis C Patients with progression to cirrhosis

Colon Cancer Screening

The number of colon cancer patients is increasing due to lifestyle behaviors such as excessive consumption of barbecued and processed foods, regular alcohol intake, high stress, and lack of exercise. Colon cancer screening, therefore, is important and should not be ignored as it helps detect colon cancer in its early stages and reduces the mortality rate. Colon cancer screening includes:

1. Fecal Occult Blood Test (FOBT/FIT) is recommended once a year, including
   • FOBT (Fecal Occult Blood Test) or FIT (Fecal Immunochemical Test)
   • Checking for invisible blood in the stool
2. Stool DNA Methylation Test for Colorectal Cancer Screening is used to detect genetic alterations (DNA) in the form of DNA Methylation that causes abnormal cell growth and rapid spread in colon cancer cells or cells prone to becoming cancerous.
3. Sigmoidoscopy is recommended every 5 years (if combined with yearly FIT).
4. Colonoscopy is recommended every 10 years if no abnormalities are found.
5. CT Colonography (Virtual Colonoscopy) uses CT Scan to simulate a colon image and is recommended every 5 years.

Groups that should undergo screening

• People aged 45 and above
• Those with chronic constipation
• Individuals consuming large quantities of meat
• Regular smokers and alcohol drinkers
• Individuals with a family history of colon cancer

Prostate Cancer Screening

Prostate cancer is common in older men and significantly affects their quality of life, causing urethral obstruction and damaging normal prostate cells. If severe, it may spread to other organs, leading to disability. Prostate cancer screening includes:

1. PSA Blood Test (Prostate-Specific Antigen) measures the protein level produced by the prostate gland.
   • Normal value < 4.0 ng/mL (but may vary with age)
   • If the level is high, it may be due to cancer, enlarged prostate, or prostatitis.
2. Digital Rectal Examination (DRE) involves a doctor using a finger through the rectum to check the prostate size, shape, and firmness.
3. Combined Evaluation
   • Using PSA + DRE results to increase screening accuracy
   • If abnormalities are found, additional tests such as MRI or Biopsy (tissue sample) may be recommended.

Groups that should undergo screening

• Men aged 50 and above
• Men experiencing abnormal urination, such as difficulty urinating or incomplete urination, which may contain blood
• Men who smoke regularly
• Men consuming high-fat animal products
• Individuals with a family history of prostate cancer

Cervical Cancer Screening

Cervical cancer is common among Thai women, caused by HPV infection, which can be either cancer-causing or non-cancer-causing. In the early stages, it often shows no abnormal symptoms until it becomes severe, causing vaginal bleeding, abnormal discharge, and pain. Therefore, cervical cancer screening is very important as it helps reduce severity and mortality rates and includes:

1. Pap Smear for Cervical Cell Abnormalities (Papanicolaou Test) is recommended every 3 years if normal.
2. Human Papillomavirus (HPV) Detection (especially cancer-causing strains) (HPV DNA Test), recommended every 5 years or combined with Pap Smear (Co-Testing) every 5 years.
3. Visual Inspection with Acetic Acid (VIA) to observe the cervix after applying vinegar is popular in resource-limited countries.

The Department of Health recommends that women aged 30-60 undergo screening every 5 years with VIA or Pap Smear. If the screening results are abnormal, further testing with Colposcopy or Biopsy will follow.

Groups that should undergo screening

• Women aged 25-65
• Women with a history of sexual intercourse
• Women without a total hysterectomy history not due to cervical cancer
• Women without a history of cervical cancer, who might need special monitoring

Various Cancer Screenings

Screening for various types of cancer is a widely accepted method, especially among high-risk groups, such as those with a family history of cancer at a young age, showing abnormal symptoms, and having various risk factors. Detecting cancer at an early stage helps patients receive effective treatment and increases the chance of a cure; it also helps reduce mortality rates. Therefore, cancer screening should be done yearly. It is advisable to consult a doctor for suitable health care guidance.

Where to Find Expert Cancer Treatment Hospitals

Watthanoth Hospital is equipped with state-of-the-art tools and technology. Their experienced specialist doctors offer various cancer screenings and choose the right treatment methods. They have a multidisciplinary team that provides close care and advice, allowing patients to regain their quality of life and live confidently.

Expert Cancer Treatment Doctors

Dr. Kakanan Teinchai, an oncologist at Watthanoth Hospital

You can click here to make an appointment yourself.

Cancer Screening Packages

Cancer screening packages start at 6,500 baht

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