Cancer is now the second most common cause of death amongst New Zealanders.
Nearly 30% of our population will succumb to some form of cancer in their lifetime.
Current statistics show that the top three cancers in men are lung cancer, followed by bowel cancer then prostate cancer. Prostate cancer is on the increase and is expected to become the most common cancer in men within the next decade or so.
Breast cancer remains the number one cancer killer in women, followed by bowel cancer and lung cancer. For Maori women, the death rate from lung cancer now equals that of Maori men and is five times higher than that of non-Maori women.
Having a healthy lifestyle, behaving sensibility and following the screening recommendations set out by your doctor are the main ways that you can avoid developing cancer, or if you do happen to develop a cancer maximise your chances of a cure. Approximately one third of all cancers are now completely curable although it is obviously better not to be in this group!
Overseas research has shown that 80% of all cancers can be prevented if we take four simple steps.
1. Eat plenty of fruit, vegetables and cereals (in other words keep your dietary fibre intake up).
2. Remain physically active.
3. Avoid tobacco smoke (this includes passive smoking).
4. Enjoy the outdoors safely using sun protection.
Remember also, that up to 10% of all cancers have a hereditary basis, particularly breast cancer, bowel cancer and malignant melanoma. It is not certain whether there is a genetic basic for prostate cancer at this point in time and further research is warranted.
In terms of screening, because some cancers can be picked up at a very early stage and thus cured completely by appropriate screening, it is wise to follow the following screening recommendations.
For Women:
1. Have a cervical smear test done on a three yearly basis at a minimum with your family doctor. Women who have ever had an abnormal cervical smear in the past should always have their smear test done on an annual basis until the age of 70.
2. For breast cancer screening, women should have an annual breast examination and screening mammogram from the age of 40 to 50 and thereafter every 2 years unless there has been a previous abnormality.
3. While it is by no means accepted that routine pelvic ultrasound for screening of ovarian cancer along with a CA125 blood test is appropriate for mass population screening, women over 50 may wish to consider this and discuss this with their doctor.
4. Have an annual skin check particularly if you have had a previous skin cancer, have a large number of moles, freckles or you burn readily.
5. Consider having a screening colonoscopy at the age of 50. Again this has not been recommended on a mass population basis, although it is becoming an increasingly commonly performed procedure to screen those who are considered at risk. If a first degree relative has had bowel cancer, have a screening colonoscopy 10 years before it was detected in that relative.
For Men:
1. Consider having a baseline colonoscopy at the age of 50 to screen for bowel cancer – see above recommendations for women.
2. Consider having a baseline rectal examination of the prostate along with a PSA blood test to screen for prostate cancer at the age of 50. There is no evidence as yet that mass population screening is worthwhile but many authorities consider at this point in time that this is the safest course of action.
3. Examine your testicles regularly, as testicular cancer is easily treated and may be fatal if left untreated. See your doctor promptly if you feel a lump or other abnormality.
4. Have an annual skin check – for the same reasons as women.
In all groups routine chest X-rays as a means for screening for lung cancer has not been shown to be effective.
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