USPSTF-recommended Tests to Screen for Cancer The U.S. Preventive Services Task Force (USPSTF) is an independent Congressionally mandated panel of experts in preventive care convened by the Agency for Healthcare Research and Quality. USPSTF rigorously reviews the evidence on the benefits and harms of behavioral counseling, preventive medications, and screening strategies related to cancer (see Figure 11, p. 58). Described below are screening tests that are included as part of evidence-based recommendations by USPSTF to screen for four cancer types in individuals who are at an average risk of being diagnosed with cancer, and to screen for lung cancer in individuals who are at a higher-than-average risk of being diagnosed with cancer. BREAST CANCER CERVICAL CANCER Digital mammography Uses X-rays to generate two dimensional images of the breast that can be stored electronically and analyzed for signs of breast cancer. Digital breast tomosynthesis Also called three-dimensional mammography, this screening method generates 3D images of the breast that are analyzed for signs of breast cancer. Must be accompanied by digital mammography. Cytology Samples cervical cells, which are analyzed under a microscope to look for abnormalities. Also called Pap test or Pap smear. High-risk Human Papillomavirus (HPV) test Detects the presence of certain cervical cancer-causing types of HPV and identifies people for whom further testing is recommended. Does not directly detect precancerous or cancerous cervical lesions. COLORECTAL CANCER Stool-based tests Some test for the presence of a product of red blood cells. Others test for both the presence of a product of red blood cell and certain genetic mutations linked to colorectal cancer. Do not directly detect precancerous lesions or cancers but identify people for whom further testing is recommended. Direct visualization tests Flexible sigmoidoscopy and colonoscopy Use a thin, flexible, lighted tube with a small video camera on the end to examine the lining of the entire colon and rectum (as is the case with colonoscopy), or only certain parts (as is the case with flexible sigmoidoscopy). Computed tomography (CT) colonography (virtual colonoscopy) Uses X-rays to image the colon and rectum. LUNG CANCER PROSTATE CANCER Low-dose spiral CT scan Uses low doses of X-rays to rapidly image the lungs and detect any structural abnormalities suggestive of lung cancer. Suspicious lesions are then biopsied to examine for the presence of abnormal or cancer cells. PSA test Measures the level of a protein called prostate-specific antigen (PSA) in blood, which is often elevated in men with prostate cancer. Does not directly detect prostate cancer but identifies men for whom further testing is recommended. Adapted from (1). PSA SIDEBAR 18 AACR Cancer Progress Report 2023 Screening for Early Detection 56
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