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Instrument Summary for Cancer Screening

Please note that this section is an archive and is no longer being updated.



1. Mammogram
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Development: Modern mammography has existed since 1969.1 There have been many technological advances with mammography and the mammograms used today are very different than those that were used 20 years ago.

Purpose: To provide a screening method for detecting cancer in the breast. A mammogram is used to detect and evaluate breast abnormalities.

Useful Facts: A mammogram is an x-ray of the breast that uses low dosage x-ray system to detect abnormalities in the breast. Mammography produces a black and white image of the breast tissue on a large sheet of film that is interpreted by a radiologist.1 Research has found that regular mammography screening can reduce breast cancer mortality by at least 30% in women who are 50 years of age or older.2 The limitation of the use of mammograms for breast cancer screening is that false-positive results may result and this often leads to further screening to exclude cancer.3

VA Relevance: Breast cancer screening using the mammogram within the VA population is similar to that of the general population.3 In recent years, the Department of Veterans Affairs has been more sensitive to the needs of women and have arranged for mammography services in or near veteran health care facilities.4 These new changes in the VA along with other health promotions and disease prevention objectives, there appears to be an increase in breast cancer screening by women veterans.4

References:

  1. Breast Cancer. American Cancer Society. Accessed December 2005. Available: http://www.cancer.org
  2. Dodendorf DM, Deogun GK, Rodie AR, Pol LG. Assessing the Patient's Mammogram Experience. Health Care Manage Review. 2004; 29(1): 77-87. [Abstract ]
  3. Lairson DR, Chan W, Newmark GR. Determinants of the Demand for Breast Cancer Screening among Women Veterans in the United States. Social Science and Medicine. 2005; 61: 1608-1617. [Abstract ]
  4. Dalessandri KM, Cooper M, Rucker T. Effect of Mammography Outreach in Women Veterans. Western Journal of Medicine. 1998; September: 169(3): 150-152. [Abstract ]




2. Fecal Occult Blood Test (FOBT)

Development: The Fecal Occult Blood Test (FOBT) was developed to detect blood in stool.1

Purpose: FOBT can be used to evaluate various intestinal conditions or screen for colon cancer in its early stages.

Useful Facts: The FOBT detects blood in the stool. It is one of the tests that helps detect colorectal cancer but it is not used for diagnosing cancer.2 The test can identify bleeding from anywhere in the digestive track, and positive results could indicate several conditions including colorectal cancer, esophagitis, gastritis, stomach cancer, ulcerative colitis and hemorrhoids.3

VA Relevance: FOBT is often used with the VA population to screen for colorectal cancer. Research has found that screening for colorectal cancer by only using FOBT may not be a good method. Other screening methods should also be added for a more thorough screening procedure.4

References:

  1. Kemp C, Potyk D. Cancer Screening: Principles and Controversies. The Nurse Practitioner. 2005; August: 30(8): 46-50. [Abstract ]
  2. Ferreira MR, Dolan NC, Fitzgibbon ML, Davis TC, Gorby N, Ladewski L, Liu D, Rademaker AW, Medio F, Schmitt BP, Bennett CL. Health Care Provider Directed Intervention to Increase Colorectal Cancer Screening Among Veterans: Results of a Randomized Controlled Trail. Journal of Clinical Oncology. 2005; March: 23(7): 1548-1554. [Abstract ]
  3. WebMD. Assessed December 2005: Available: http://www.webmd.com/hw/colorectal_cancer/hw227116.cfm
  4. Collins JF, Leiberman DA, Durbin TE, Weiss DG. Accuracy of Screening for Fecal Occult Blood on a Single Stool Sample Obtained by Digital Rectal Examination: A Comparison with Recommended Sampling Practice. Annals of Internal Medicine. 2005; January: 142(2): 81-86. [Abstract ]




3. Colonoscopy

Development: The colonoscopy was developed to help doctors look inside the entire large intestine to detect cancer and other medical problems.1

Purpose: A colonoscopy is performed to evaluate the lining of the colon for medical problems such as bleeding or cancer presence.2

Useful Facts: The colonscopy is useful in finding cancer in the rectum or colon early in the cancer process. It can be used to look for causes of unexplained changes in bowel habits and it also helps in determining causes for abdominal pain, rectal bleeding, and weight loss.3 The colonoscopy is done by using a thin, flexible viewing instrument called the colonoscope. Complications during a colonoscopy are rare; however, there is a risk of puncturing the lining of the colon during the procedure which may result in bleeding and infection.1

VA Relevance: Colonoscopy is a standard procedure used with veterans as well as the general population to screen for colon cancer. Studies that have investigated the veteran population and screening for cancer using colonscopy have found that these screenings can have a high degree of success in screening for cancer.4

References:

  1. Piscatelli N, Hyman N, Osler T. Localizing Colorectal Cancer by Colonoscopy. Arch Surg. 2005; October: 140: 932-935 [Abstract ]
  2. The Cancer Info. Accessed December 2005. Available: http://www.ontumor.com
  3. Dolan NC, Ferreira R, Fitzgibbon ML, Davis TC, Rademaker AW, Liu D, Lee J, Wolf M, Schmitt BP, Bennett CL. Colorectal Cancer Screening Among African-American and White Male Veterans. American Journal of Preventive Medicine. 2005; 28(5): 479-482. [Abstract ]
  4. Nelson DB, McQuaid KR, Bond JH, Leiberman DA, Weiss DG, Johnston TK. Procedural Success and Complications of Large-Scale Screening Colonscopy. Gastrointestinal Endoscopy. 2002; 55(3): 307-314. [Abstract ]




4. Digital Rectal Exam (DRE)

Development: The Digital Rectal Exam (DRE) was developed to screen for prostate and rectal cancer by using a finger to detect abnormalities.1

Purpose: A DRE is screening tool to detect rectal cancer and prostrate cancer which is usually done during a standard physical examination.

Useful Facts: The DRE is done by a doctor or nurse inserting a gloved, lubricated finger into the rectum to check for abnormalities. The DRE has been found to miss most early stage tumors.2 There also may be false-positive results using DRE as a cancer screening procedure.2 Research has found that the rate of false-positives are reduced with DRE when they are combined with prostrate specific antigen (PSA) test.3

VA Relevance: Research has found that regular screening for cancer has reduced the rate of mortality.4 There have not been many studies conducted that have focused primarily on the veteran population and DRE.

References:

  1. Radosevich DM, Partin MR, Nugent S, Nelson D, Flood AB, Holtzman J, Dillon N, Haas M, Wilt TJ. Measuring Patient Knowledge of the Risks and Benefits of Prostate Cancer Screening. Patient Education and Counseling. 2004; 54: 143-152. [Abstract ]
  2. Ford ME, Havstad SL, Demers R, Johnson CC. Effects of False-Positive Prostate Cancer Screening Results on Subsequent Prostate Cancer Screening Behavior. Cancer Epidemiology, Biomarkers & Prevention. 2005; January: 14(1): 190-194. [Abstract ]
  3. Hall HI, Van Den Eeden S, Tolsma DD, Rardin K, Thompson T, Sinclair AH, Madlon-Kay DJ, Nadel M. Testing for Prostate and Colorectal Cancer: Comparison of Self-Report and Medical Record Audit. Preventive Medicine. 2004; 39: 27-35. [Abstract ]
  4. Gruber M. Performance of flexible sigmoidoscopy by a clinical nurse specialist. Gastroenterology Nursing. 1996 May-Jun;19(3):105-8. [Abstract ]


[created 15 Mar 2006]