Releasing the Fear of Cancer Screenings

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Releasing the Fear of Cancer Screenings

• Prevent It
• Detect It Early
• Defeat it!

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Leading Causes of Death

• Cancer is the 2nd leading cause of death in the
  United States
• Cancer causes approximately 23 of all deaths in
  the United States

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Actual Causes of Death

• Smoking, poor diet and lack of exercise account
  for approximately 1/3 of all deaths in the United
  States

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Did you know that most cancers do not have any
symptoms until they have developed for many years?
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Reducing Risk of Cancer

• Avoid tobacco use
• Be physically active
• Maintain recommended body weight
• Avoid excessive alcohol consumption

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Detecting Pre-cancer and Cancer

• Breast Cancer
• Mammograms
• Cervical Cancer
• Pap Smears
• Colon Cancer
• Colonoscopy, Sigmoidoscopy, Fecal Occult Blood
  Test (FOBT)

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Cancer Risk Assessment

• Questions taken from the Centers for Disease
  Control and Prevention (CDC) Behavioral Risk
  Factor Surveillance System (BRFSS)
• Random telephone survey taken in all 50 states,
  D.C., Puerto Rico, Guam and the Virgin Islands
• Designed to approximate lifestyle and health
  behaviors for each state
• Comparisons made between Kentucky and the United
  States

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Question 1 What is your average frequency of
fruit and vegetable consumption per day?
Numbers are percentages from 2002 survey
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Question 1 What is your average frequency of
fruit and vegetable consumption per day?
Numbers are percentages from 2002 survey
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Goals for Fruit and Vegetable Consumption

• Healthy Kentuckians 2010 Goal 2.5
• Increase to at least 40 percent the proportion of
  people age 2 and older who meet the Dietary
  Guidelines minimum average daily goal of at
  least five servings of vegetables and fruits

Source Healthy Kentuckians 2010
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Recommendations for Fruit and Vegetable
Consumption

• ACS Cancer Facts Figures 2004
  recommendations
• Eat a variety of healthful foods, with an
  emphasis on plant sources.
• Eat five or more servings of vegetables and
  fruits each day.
• Choose whole grains instead of processed
  (refined) grains and sugar.
• Limit consumption of red meats, especially
  high-fat and processed meats.
• Choose foods that help maintain a healthful weight

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Question 2 During the past month, did you
participate in any physical activities?
Numbers are percentages from 2002 survey
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Question 2 During the past month, did you
participate in any physical activities?
Numbers are percentages from 2002 survey
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Goals for Exercise

• Healthy Kentuckians 2010 Goal 1.2
• To increase to at least 50 the proportion of
  Kentuckians ages 18 and older who engage
  regularly in physical activity for at least 20
  minutes 3 or more times per week.

Source Healthy Kentuckians 2010 and American
Cancer Society
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Recommendations for Exercise

• ACS Cancer Facts Figures 2004
  recommendations
• Adults Engage in at least moderate activity for
  30 minutes or more on 5 or more days of the week
  45 minutes or more of moderate to vigorous
  activity on 5 or more days per week may further
  enhance reductions in the risk of breast and
  colon cancer.
• Children and Adolescents Engage in at least 60
  minutes per day of moderate to vigorous physical
  activity at least 5 days per week.

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Question 3 Do you smoke cigarettes now?
Numbers are percentages from 2002 survey
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Question 3 Do you smoke cigarettes now?
Numbers are percentages from 2002 survey
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Goals for Reducing Smoking

• Healthy Kentuckians 2010 Goal 3.1
• Reduce the proportion of adults (18 and older)
  who use tobacco products.
• Cigarettes 1998 Baseline 30.8, target for 2010
  25 (20 percent improvement)

Source Healthy Kentuckians 2010
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Recommendations for Reducing Smoking

• ACS Cancer Facts Figures 2004
• Cigarette smoking among adults aged 18 and older
  declined 40 between 1965 and 2000 from 42 to
  22
• Smoking is the most preventable cause of death in
  our society. In 2000, about 4.9 million
  smoking-related, premature deaths occurred
  throughout the world
• Approximately half of all Americans who continue
  to smoke will die from their cigarette smoking
  addiction
• Smoking accounts for at least 30 of all cancer
  deaths and 87 of lung cancer deaths

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Question 4 How many times during the past month
did you have 5 or more drinks on an occasion?
Numbers are percentages from 2002 survey
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Question 4 How many times during the past month
did you have 5 or more drinks on an occasion?
Numbers are percentages from 2002 survey
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Goals for Reducing Alcohol Consumption

• Healthy Kentuckians 2010 goal 26.12
• Reduce alcohol consumption in Kentucky to an
  annual average of no more than 2 gallons of
  ethanol per person.
• Baseline of 1994 national average of 2.21 gallons.

Source Healthy Kentuckians 2010
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Recommendations for Reducing Alcohol Consumption

• ACS Cancer Facts Figures 2004 recommendation
• People who drink alcohol should limit their
  intake to no more than 2 drinks per day for men
  and 1 drink a day for women.
• Alcohol consumption is an established cause of
  cancers of the mouth, pharynx, larynx, esophagus,
  liver and breast.

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Question 5 If you are 50 or older, have you
ever used a home blood stool test kit to
determine whether your stool contained blood?
Numbers are percentages from 2002 survey
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Question 5 If you are 50 or older, have you
ever used a home blood stool test kit to
determine whether your stool contained blood?
Numbers are percentages from 2002 survey
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Question 6 When did you have your last blood
stool test using a home kit?
Numbers are percentages from 2002 survey
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Question 6 When did you have your last blood
stool test using a home kit?
Numbers are percentages from 2002 survey
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Goals for Home Blood Stool Test

• Healthy Kentuckians 2010 goal 17.8
• To increase to at least 35 the proportion of
  people ages 50 and older who have received fecal
  occult blood (home blood stool) testing within
  the preceding one to two years

Source Healthy Kentuckians 2010
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Recommendations for Home Blood Stool Test

• ACS Cancer Facts Figures recommendations
• Beginning at age 50, men and women who are at
  average risk for developing colorectal cancer
  should have fecal occult blood test (FOBT)
  annually
• following the recommended take-home method
  involving sampling stool from several consecutive
  bowel movements

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Reducing fear of Home Blood Stool Tests

• You receive a test kit from your doctor or health
  care provider
• At home, you put a small piece of stool on a test
  card
• You do this for 3 bowel movements in a row
• Return the test cards to the doctor or a lab
• The stool samples are checked for blood

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Question 7 If you are 50 or older, Have you
ever had a sigmoidoscopy or colonoscopy exam?
Numbers are percentages from 2002 survey
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Question 7 If you are 50 or older, Have you
ever had a sigmoidoscopy or colonoscopy exam?
Numbers are percentages from 2002 survey
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Question 8 When did you have your last
sigmoidoscopy or colonoscopy exam?
Numbers are percentages from 2002 survey
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Question 8 When did you have your last
sigmoidoscopy or colonoscopy exam?
Numbers are percentages from 2002 survey
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Goals for Sigmoidoscopy and Colonoscopy

• Healthy Kentuckians 2010 goal 17.8
• To increase to at least 40 the proportion of
  people ages 50 and older ever received a
  sigmoidoscopy.

Source Healthy Kentuckians 2010
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Recommendations for Sigmoidoscopy and Colonoscopy

• ACS Cancer Facts Figures recommendations
• Beginning at age 50, men and women who are at
  average risk for developing colorectal cancer
  should have sigmoidoscopy every 5 years or
• The combination of annual FOBT and flexible
  sigmoidoscopy every 5 years (this combination is
  preferred over either method alone)
• Colonoscopy (if normal, repeat every 10 years)
• FOBT in the doctors office following a digital
  rectal exam is not recommended.

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Reducing fear of Sigmoidoscopy

• The doctor puts a short, thin, flexible, lighted
  tube in your recturm
• The doctor checks for polyps (pre-cancer) or
  cancer inside the rectum and lower third of the
  colon

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Reducing fear of Colonoscopy

• The doctor puts a long, thin, flexible, lighted
  tube in your rectum
• The doctor checks for polyps (pre-cancer) or
  cancer inside the rectum and entire colon
• During the test, the doctor can find and remove
  most polyps and some cancers

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Question 9 If you are a woman 40 or older, have
you ever had a mammogram?
Numbers are percentages from 2002 survey
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Question 9 If you are a woman 40 or older, have
you ever had a mammogram?
Numbers are percentages from 2002 survey
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Question 10 How long has it been since your
last mammogram?
Numbers are percentages from 2002 survey
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Question 10 How long has it been since your
last mammogram?
Numbers are percentages from 2002 survey
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Goals for Mammography

• Healthy Kentuckians 2010 goals 17.5
• To increase to at least 85 the proportion of
  women ages 40 and older who have ever received a
  Clinical Breast Exam (CBE) and mammogram, and
• To at least 85 those ages 50 and older who have
  received a CBE and mammogram within the preceding
  one to two years.

Source Healthy Kentuckians 2010
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Recommendations for Mammography

• ACS Cancer Facts Figures recommendations
• The American Cancer Society recommends that women
  age 40 and older have an annual mammogram and
  annual clinical breast examination by a health
  care professional (close to and preferably before
  the scheduled mammogram).
• Women in their 20s and 30s should have a
  clinical breast examination by a health care
  professional, preferably at least every three
  years.

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Reducing fear of Mammograms

• X-Ray of the Breast
• The breast is squeezed between 2 plastic plates
  attached to the mammogram machine unit in order
  to spread the tissue apart.
• Compression insures
• that movement is minimized
• that the image is sharper
• that the exam can be done with a lower x-ray
  dose.
• Although this compression may be uncomfortable,
  it only lasts for a few seconds and is necessary
  to produce a good mammogram.
• The entire procedure for a mammogram takes about
  20 minutes.

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Question 11 If you are a woman, have you ever
had a Pap smear?
Numbers are percentages from 2002 survey
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Question 11 If you are a woman, have you ever
had a Pap smear?
Numbers are percentages from 2002 survey
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Question 12 How long has it been since your
last Pap smear?
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Question 12 How long has it been since your
last Pap smear?
Numbers are percentages from 2002 survey
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Goals for Pap smear utilization

• Healthy Kentuckians 2010 goals 17.6
• To increase to at least 95 the proportion of
  women ages 18 and older who have ever received a
  Pap test,
• To at least 85 those who received a Pap test
  within the preceding one to three years.

Source Healthy Kentuckians 2010
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Recommendations for Pap smear utilization

• ACS Facts Figures 2004 recommendation
• The American Cancer Society recommends cervical
  cancer screening should begin approximately 3
  years after a woman begins having vaginal
  intercourse, but no later than 21 years of age.
• It should be done every year with regular pap
  tests or every two years using liquid based test.
  
• At or after age 30, women who have had 3 normal
  tests in a row may get screened every 2-3 years.
  But doctors may suggest getting the test more
  often if a women has certain risk factors such as
  HIV infection or a weak immune system.
• Women 70 years of age and older who have had 3 or
  more normal Pap tests and no abnormal Pap test in
  the last 10 years may choose to stop cervical
  cancer screening.

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Reducing fear of Pap Smears

• The Pap test, or Pap smear, is a way to check
  cells from the cervix (the lower part of the
  uterus or womb) and the vagina.
• The health care professional first inserts a
  speculum, a metal or plastic instrument that
  keeps the vagina open so that the cervix can be
  seen clearly.
• Next, a sample of cells and mucus is lightly
  scraped from the ectocervix (part next to the
  vagina) using a small spatula.
• A small brush or a cotton-tipped swab is used to
  take a sample from the endocervix (part closest
  to the body of the uterus).
• Specially trained technologists
  (cytotechnologists) and doctors (pathologists)
  examine the samples under a microscope

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Tips on Pap Smears

• Don't use tampons, birth-control foams, jellies
  or other vaginal creams for 2 - 3 days before the
  test
• There is no need to douche at all, but if you do,
  don't douche for 2 - 3 days before the test
• Do not have sexual intercourse for 2 days before
  the test
• Try not to schedule your Pap test during your
  menstrual period
• The best time is at least 5 days after your
  menstrual period stops
• Without taking these precautions, your pap smear
  results may be inaccurate

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Overall Recommendations

• Visit your doctor annually
• Dont smoke
• Exercise regularly
• Eat fruits and vegetables often
• Avoid excessive alcohol use
• Get Screened!

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Getting screened helps get some cancers BEFORE
they get you!
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Questions??
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For more information

• About cancer prevention, detection and treatment
• Call 1-800-4-CANCER (422-6237)
• To enroll in a Cooper Clayton Smoking Cessation
  Class
• Call 219-0772
• To find out about the new self-help smoking
  cessation study
• Call 1-877-44U-QUIT (448-7848)

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References

• American Cancer Society. Cancer Facts and
  Figures 2004. http//www.cancer.org/docroot/STT/st
  t_0.asp
• Minino AM, Arias E, Kochanek KD, Murphy SL, Smith
  BL. Deaths final data for 2000. Natl Vital
  Stat Rep. 2002501-120.
• Mokdad AH, Marks JS, Stroup DF, Gerberding JL.
  Actual Causes of Death in the United States,
  2000. JAMA. March 10, 2004291(10)1238-1245
• Division of Adult and Community Health, National
  Center for Chronic Disease Prevention and Health
  Promotion, Centers for Disease Control and
  Prevention, Behavioral Risk Factor Surveillance
  System Online Prevalence Data, 1995-2002
• Kentucky Department for Public Health. Healthy
  Kentuckians 2010. http//chs.state.ky.us/publichea
  lth/healthy_ky_2010.htm

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Jennifer Redmond, MPHAssistant Director for
Community Programs, Markey Cancer
Centerjredmond_at_kcp.uky.edu [phone] x252