THE BIG “C” – Cancer Screening

In our last edition we discussed the increasing rates of cancer and which kinds of cancer were at the top of the hit parade. Now lets look at how cancer screening and early detection can improve the outcomes of many of these cancers.


Skin Cancer

While regular screening is not recommended for all people, those at risk should seek and annual check at a skin cancer-screening center.

People at high risk for skin cancer include those with:

  • fair skin, a tendency to burn rather than tan, freckles,

light eye colour, light or red hair colour;

  • increased numbers of unusual moles (dysplastic naevi);
  • depressed immune systems;
  • a family history of melanoma in a first degree relative; and
  • previous melanoma or non-melanoma skin cancers
  • those who have had high levels of sun exposure

(water sports, outdoors employment etc).


Breast cancer

All women should know how their breasts normally look and feel. Self-breast examination should be conducted every month and any breast changes reported to a health care provider right away. Some women who may high risk (2 or more relatives with cancer of the breasts, ovaries, uterus or prostate) or certain other factors – should be screened with MRIs along with mammograms.


In general:

  • Women ages 40 to 44 should have the choice to start

annual breast cancer screening with mammograms

(x-rays of the breast) if they wish to do so.

  • Women age 45 to 54 should get mammograms every year.
  • Women 55 and older should switch to mammograms

every 2 years, or can continue yearly screening.

Ultrasound scan may also be recommended as an extra diagnostic tool.


Colon and rectal cancer and polyps

Starting at age 50, both men and women should have a fecal blood test screening. If this test is positive a colonoscopy should be performed. This is a good basic screening test, however, in advanced medical facilities other more advanced less invasive tests may be offered.

If you are at high risk of colon cancer based on family  history or other factors, you may need to be screened using a different schedule.


Cervical cancer

  • Cervical cancer testing should start 2 years after sexual

activity commences.

  • Women between the ages of 21 and 29 should have a

Pap test done every 3 years. HPV testing should not be

used in this age group unless it’s needed after an

abnormal Pap test result.

  • Women between the ages of 30 and 65 should have a

Pap test plus an HPV test done every 5 years. This is the

preferred approach, but it’s OK to have a Pap test alone

every 3 years.

  • Women over age 65 who have had regular cervical

cancer testing in the past 10 years with normal results

should not be tested for cervical cancer. Once testing is

stopped, it should not be started again. Women with a

history of a serious cervical pre-cancer should continue to

be tested for at least 20 years after that diagnosis, even

if testing goes past age 65.

  • A woman who has had her uterus and cervix removed

(a total hysterectomy) for reasons not related to cervical

cancer and who has no history of cervical cancer or

serious pre-cancer should not be tested.

  • All women who have been vaccinated against HPV should

still follow the screening recommendations for their age



Endometrial (uterine) cancer

All women at the time of menopause, should be told about the risks and symptoms of endometrial cancer. Women should report any unexpected vaginal bleeding or spotting to their doctors.


Lung cancer

Routine screening is generally not recommended unless you are hi-risk. Screening might be right for you if you are all of the following:

  • 55 to 74 years of age
  • Have at least a 30 pack-year smoking history AND are

either still smoking or have quit within the last 15 years

(A pack-year is the number of cigarette packs smoked

each day multiplied by the number of years a person has

smoked. Someone who smoked a pack of cigarettes per

day for 30 years has a 30 pack-year smoking history,

as does someone who smoked 2 packs a day for 15

years.) OR if you have lived with a heavy smoker in

a closed living or working space.


Prostate cancer

Starting at age 50, men should talk to a health care provider about their risk factors and which testing is the right choice for them. If you are African American or have a father or brother who had prostate cancer before age 65, you should get a PSA blood test with or without a rectal exam. How often you’re tested will depend on your PSA level.


Take control of your health, and help reduce your cancer risk.

  • Stay away from all forms of tobacco.
  • Get to and stay at a healthy weight.
  • Get moving with regular physical activity.
  • Eat healthy with plenty of fruits and vegetables.
  • Limit how much alcohol you drink (if you drink at all).
  • Protect your skin.
  • Know yourself, your family history, and your risks.
  • Get regular check-ups and cancer screening tests.

Remember – many of these cancers have no symptoms in the early stages and early detection of any of these cancers will always improve the outcome of any treatment ☺


Kim Patra is a qualified Midwife & Nurse Practioner who has been living and working in Bali for over 30 years. She now runs her own Private Practice & Mothers & Babies center at her Community Health Care office in Sanur.


Kim is happy to discuss any health concerns that you have and may be contacted via email at, or office phone   085105-775666 or Bali


Copyright © 2018 Kim Patra

You can read all past articles of

Paradise…in Sickness & in Health at