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Early Detection of Cancer in Women
Dr. Shirin

Cancer is the second leading cause of death after heart disease in most developed countries. It accounts for an estimated 540,000 deaths annually in the US alone.

The various cancers common in women are:

  1. Cancer Breast
  2. Cancer Cervix
  3. Cancer Uterus
  4. Cancer Ovary

Cancer Breast:

It is the second leading cause of death in women in the US. In men the incidence is 1:1 million. 80% of the women diagnosed with breast cancer have no known risk factors. 5-10% have a family history of Breast cancer & only 10% have some risk factors.

Risk factors:

  • Age: highest age incidence is around 50.
  • Family history is 2-3 times more frequent among sufferers.
  • Smoking, Alcohol, diet rich in fat are all included as additional risk factors.
  • Early menarche (age at first period) late menopause, late first child. Research reveals that the mortality rate could decrease by 30% if all women age 50 years and above who are in need of a mammogram had one.
Screening methods:
  • Breast self examination: It is done after every period. Each breast is examined by dividing it into four quadrants, the shape and contour are also inspected.
  • Mammogram: It should be undertaken once as a baseline at age 35-39 and then at 2 years intervals between 40-49 years and then annually.
  • Ultrasonography: Can demonstrate the difference between cystic and solid lesions. Cystic lesions are generally benign.
  • Core Biopsy or fine needle aspiration may be required to confirm the nature of the lump.
  • Surgical excision of the lump.
  • CTLM (computed tomography laser mammography) is a recent advance and offers painless alternative to mammogram.

Cancer Cervix:

It is one of the three most common sites of gynaec cancers. It is the most common cancer in the world for women. The most important information is that an extensive analysis of data from large screening program estimates that annual screening, reduces the probability of invasive cancer cervix by 93.3% in women so screened.

Risk factors:
  • Early sexual activity
  • Multiple sex partners
  • Smoking and oral contraceptive pills
  • Infection with Human papilloma virus.
Screening Test

It is a simple, inexpensive technique by which cells are collected from the cervix and a smear is made and stained in a particular way, which diagnoses the cancer cells. It is called a PAPsmear. It is recommended that every sexually active woman under goes, it every year till age 65 years.
Endometrial Cancer

Is the most common gynae malignancy but tends to be diagnosed early as it causes vaginal bleeding.

Risk factors:
  • Obesity
  • Age incidence - highest around 61 years
  • Nulliparity (no child)
  • Late menopause
  • Polycystic ovarian disease
  • Drugs such as Exogenous estrogens, tamoxifen
  • Oral contraceptives reduce the risk
  • Ultrasound post menopausally
  • Pipelle aspirator to check cells lining the uterus.

Ovarian Cancer

Leading cause of death from gynae cancer as it is usually diagnosed in a late stage.

Risk factors:
  • Family history
  • Nulliparity & or late pregnancy, oral contraceptive, breast feeding, increased number of children, tubal ligation & hysterectomy are some factors that reduce the risk.
  • Nowadays a blood test (CA125) is used to check out for cancer ovary in high-risk patients but it is not a screening test. Added to this an ultra sound which detects the blood flow through the ovary is also useful.
In Conclusion I would like to emphasize regular check ups and hope to increase awareness among women regarding their health and wellbeing.

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