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American Cancer Society's New Initiative, Physician Practice Strategy Plus: A Powerful Team

Posted on: Sunday, 8 May 2005, 03:00 CDT

Cancer is now the leading cause of death for Americans under the age of 85. The American Cancer Society estimates over 1.3 million new cases will be diagnosed this year, and of those, over 570 thousand people will die of this disease.

Evidence suggests cancers that can be prevented by earlier screening account for about half of all new cases. In Kentucky, over 23 thousand new cases are expected in 2005. The five-year survival rate for people with cancers for which there are early detection screening guidelines is 82 percent. If all Americans had early detection testing, according to the American Cancer Society recommendations, that survival rate would increase to nearly 95 percent.

This is of particular concern to Dr. Robert Martin, Surgical Oncologist and Cancer Liaison for University of Louisville Hospital/ Brown Cancer Center and Norton Hospital of Louisville. He has taken a lead role with the American Cancer Society's Physician Practice Strategy Plus: A Powerful Team, the intent of which is to educate physicians about the American Cancer Society's Cancer screening guidelines and put them into practice with their patients.

"I am committed to the belief that if we only increase the number of Kentuckians participating in the appropriate screening, overall survival and ultimately, quality of life will be improved throughout the state," said Martin. There are a significant number of Kentuckians who are not undergoing basic screening for breast and colorectal cancer. Kentucky ranks in the lowest quarter of all states in screenings."

Martin adds, "I believe it is important for physicians to empower the patients to understand the importance of screening guidelines and ensure they comply with them."

The challenge comes in educating patients about the benefits of cancer screening, and just as importantly, educating health care professionals about when it is appropriate to recommend screening. This is the purpose of the American Cancer Society's new initiative. Physician Practice Strategy Plus: A Powerful Team.

This plan takes a two-pronged approach, providing patient education materials to the individual through his/her community groups, and providing health care professionals with companion information for their offices. In addition, the American Cancer Society has a number of tools available to help ensure that the patients actually comply with the recommended screenings.

To learn more about Physicians Practice Strategy Plus: A Powerful Team, or about the American Cancer Society screening guidelines, call 1-800-ACS-2345 or visit www.cancer.org.

Following are the recommended cancer screening guidelines for asymptomatic people:

Breast:

* Yearly mammograms are recommended at age 40 and should continue as long as the woman is in good health.

* Clinical Breast Exam should be a part of a periodic health exam- about every three years for women in their 20's and 30's and every year for women 40 and older.

* Women should know how their breasts normally feel and should promptly report any breast change to their health care provider. Breast Self Exam is an option for women starting in their 20's.

* Women at increased risk, (e.g. family history, genetic tendency, past breast cancer) should talk with their doctors about the benefits and limitations of starting mammograms earlier, having additional tests, or having more frequent exams.

Colon

Beginning at age 50, the American Cancer Society recommends both men and women follow one of the following five testing options:

* Yearly fecal occult blood test (FOBT)

* Flexible Sigmoidoscopy every five years

* Yearly FOBT and Flexible Sigmoidoscopy every five years (preferred over either option alone)

* Double contrast barium enema every five years

* Colonoscopy every ten years

Note:

* All positive tests should be followed up with colonoscopy.

* People should begin colon testing earlier and/or undergo more frequent testing if they have the following colon cancer risk factors: Personal history or family history of colon cancer, personal or family history of intestinal polyps, personal history of inflammatory bowel disease, certain genetic factors (such as familial adenomatous polyposis, Gardner's syndrome, and hereditary non-polyposis colorectal cancer.)

Prostate

* Both prostate specific antigen (PSA) and digital rectal examination (DRE) should be offered annually, beginning at age 50, to men with a life expectancy of at least 10 years.

* Men at high risk (African American men and men with a strong family history of one or more first-degree relatives diagnosed with prostate cancer at an early age) should begin testing at age 45.

* For both men at average risk and high risk, information should be provided about the benefits and limitations of early detection and treatment of prostate cancer so that they may make an informed decision about testing.

* Men who ask their doctor to make the decision on their behalf should be tested. Discouraging testing is not appropriate.

Uterus/Cervix

* Screening should begin three years after women begin having sexual intercourse, but no later than age 21. Screening should be done every year with regular Pap test, or every two years with the liquid based Pap test.

* Beginning at age 30, women who have had three normal Paps in a row may get screened every two to three years, unless at high risk (HIV or weak immune system)

* Women 70 and over who have had three or more normal Pap tests in the last 10 years may choose to stop cervical cancer screening. Testing after total hysterectomy is not necessary unless surgery was done as treatment for cervical cancer or pre-cancer.

Uterus/Endometrial

* American Cancer Society recommends that all women should be informed about risks and symptoms of endometrial cancer, and are strongly encouraged to report any unexpected bleeding or spotting to their health care provider.

* Annual screening with endometrial biopsy beginning at age 35 should be offered to women with or at high risk for hereditary nonpolyposis colon cancer (HNPCC).

Cancer Related Checkup

* For individuals undergoing periodic health examinations, a cancer related checkup should include health counseling, and depending on the person's age, might include examinations for cancers of the thyroid, oral cavity, skin, lymph nodes, testes and ovaries, as well as for some nonmalignant diseases.

Ellen Schroeder, Health Initiatives Representative

American Cancer Society

Copyright Kentucky Nurses Association Apr-Jun 2005

Source: Kentucky Nurse

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