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Early Detection Strategies an Important Way to Reduce Risk of Cancer:
Morningstar's Story
People often talk about finding a cure for cancer, but many cancers can
be “curable” and even preventable if people take advantage of the
appropriate and available tests. Besides avoiding tobacco products and
maintaining a healthy weight, regular cancer testing (or “screening”)
is the most important way to reduce the chances of dying from the
disease.
Early detection tests can find cancers before a person has symptoms or
feels sick, and many cancers found in the early stages can often be
treated successfully. Some tests, like the tests for colon and cervical
cancers, can even prevent cancer by identifying precancerous changes
that, if removed, can prevent the cancer from developing.
The proof is in the numbers. Thanks to the Pap test, cervical cancer
cases and deaths have dropped by more than 70 percent in the past three
decades. More recently, the newly FDA-approved human papilloma virus
(HPV) vaccine also has the potential to prevent up to 70 percent of
cervical cancers.
Another example: Because of the growing public acceptance of
mammography, 68 percent of female breast cancers in California are
detected at early stages when the five-year survival rate is over 95
percent. Due to the combined effects of better treatment and earlier
diagnosis, the breast cancer death rate in California has decreased by
29 percent since 1988, according to the American Cancer Society.
Studies have suggested that lesbian, gay, bisexual and transgender
people access healthcare, including cancer screenings, less frequently
than the general population. For instance, lesbians report having fewer
mammograms and pelvic exams and less-frequent Pap tests than
heterosexual women. Issues such as the lack of access to care and the
experience of insensitive care at the hands of their providers may keep
LGBT folks from visiting a physician.
LGBT people may not want to self-identify to their health care
providers because they don’t want discrimination to affect the quality
of health care they receive. Additionally, many health insurance
polices do not cover unmarried partners, making it harder to access
quality health care. As a result, lifesaving early detection messages
may not be received in a timely way, placing people at greater risk.
Finally, negative experiences with providers may cause LGBT people to
postpone lifesaving cancer screening tests.
San Francisco resident Morningstar Vancil’s story is one that
underscores several of these this points. For months Morningstar, a
lesbian of color who was born in the Philippines, complained to her
doctor about constant bleeding and fatigue, only to be told that the
problem was menopause without receiving examination or testing. The
uterine tumor, when it was discovered in 2003, was Stage III.
Even as Morningstar was fighting for her life, she had to struggle
against ignorance and bias because of her sexuality. While she prepared
for surgery, a staff person in her physician’s office announced to the
waiting room that Morningstar would “never have gotten cancer if [she
had] married a man.” Her complaints about the incident led to the
hospital’s adopting ongoing sensitivity training for all staff.
Morningstar underwent a hysterectomy and an aggressive chemotherapy and
radiation regimen over ten months during 2003-2004 and is now in
remission. She is the only person out of several in her family who has
been diagnosed with cancer and survived.
As Morningstar well knows, for women with no health insurance, poor
insurance policies, between jobs, or at low- income levels, routine
cancer screening tests such as mammography may cost too much. And the
government program currently in place to help these women get these
tests on schedule is struggling.
The Centers for Disease Control and Prevention‘s National Breast and
Cervical Cancer Early Detection Program (NBCCEDP) is currently saving
lives in all 50 states. The program also helps reduce the high medical
costs of treating late-stage cancer. With more than 21,000 service
sites throughout the United States, women who are subsequently
diagnosed with breast or cervical cancer through the program are
eligible for treatment through Medicaid under the National Breast and
Cervical Cancer Treatment Act, a law the American Cancer Society helped
pass.
To date, the program has provided more than four million screening
exams to underserved women. But it needs more funding to serve all
eligible women.
Today, there is only enough funding to screen 1 in 5 women eligible for
the program. The result is that millions of women are going without
life-saving screenings and treatment. The American Cancer Society
is working to secure an additional $45 million in federal funding for
NBCCEDP, which would bring the program’s total budget to $250 million –
allowing 130,000 more women to be reached with lifesaving testing each
year.
Morningstar is one of several thousand cancer survivors and others
impacted by the disease who has been selected to visit the US capital
in September 2006 as part of the American Cancer Society’s “Celebration
on the Hill.” She will speak to her elected officials about the
importance of fully funding the program and increasing funding for
cancer research.
The Society’s nonpartisan, nonprofit sister advocacy organization, the
American Cancer Society Cancer Action Network (ACS CAN) is leading a
drive to make sure that all women who are eligible for this program get
the tests they need. Learn more or get involved at www.acscan.org. To
find out more information to help you reduce your risk of cancer, call
the American Cancer Society at 1-800-ACS-2345 or visit www.cancer.org.
SIDEBAR:
According to American Cancer Society recommendations for the early
detection of cancer, here are some important things women and
female-to-male transgender persons should discuss with their healthcare
providers:
Breast cancer – From age 20-39, clinical breast examinations every
three years; age 40 or older, have an annual mammogram and have regular
clinical breast exams. Breast self-examination is an additional way to
be aware of any additional changes in the breasts.
Cervical cancer – Cervical cancer can affect any woman who is or has
been sexually active with a man or woman. Begin screening with Pap test
and pelvic examination no later than 21 years of age on an annual
basis; for those older than age 30 who have had 3 consecutive normal
tests, screening may be every two to three years.
Ovarian cancer – Regular, thorough pelvic exams are recommended because
they can find some reproductive system cancers at an early stage;
however, most early ovarian tumors are difficult or impossible for even
the most skilled examiner to feel.
Colon cancer – Age 50 or older, follow ONE of these five testing options:
• Yearly fecal occult blood test (FOBT)
• Flexible sigmoidoscopy every five years
• Yearly FOBT and flexible sigmoidoscopy every five years (preferred over either option alone)
• Double contrast barium enema every five years
• Colonoscopy every 10 years
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