Wellness Wednesday: Cancer screening and prevention

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Regular exercise has many benefits, including cancer prevention. (Jay Gabler/MPR)
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The urgency of the COVID-19 pandemic has understandably been causing many people to sideline other aspects of their health, but unfortunately cancer won't rest while we fight the coronavirus. Some screening can be done remotely, and there are things you can do every day to help prevent cancers from forming in your body.

Today we've got Timothy Church as our guest. He's a professor in the Division of Environmental Health Sciences of the University of Minnesota School of Public Health, and a Masonic Cancer Center member. Prof. Church talked about cancer prevention, especially in the light of a recent New York Times report about a lot of people skipping their normal cancer screenings.

Every Wednesday morning at 8:30 CST, Jill Riley (with guest host Sean McPherson today) connects with experts and local personalities for some real talk about keeping our minds and bodies healthy — from staying safe in the music scene, to exercising during a pandemic, to voting and civic engagement. Looking for more resources and support? Visit our friends at Call to Mind, MPR's initiative to foster new conversations about mental health. Subscribe to Wellness Wednesday as a podcast on Spotify, Apple, RSS, Radio Public, Stitcher, or Amazon Music.

Sean McPherson: In general, what is the logic behind cancer screenings and how do they work?

Timothy Church: Okay, well, a little background. First of all, we expect about two million cases in the US in 2021, and over 600,000 deaths from cancer. Screening and prevention are extremely important. The University of Minnesota has been a world leader, researching and promoting cancer screening. We've been doing that for five decades. We started with a colon cancer control study in 1974, which showed that using fecal occult blood screening could reduce colorectal cancer mortality by about a third and reduce its incidence by about a fifth; the incidence meaning the number of diagnoses.

So this was a first indication that you could screen for colorectal cancer and prevent death and suffering. In the meantime, we've also extensively researched screening for prostate, lung, ovarian cancer and also looked at trying to prevent cancer by dietary nutrients of calcium, aspirin, vitamin D, that sort of thing.

Now, currently, breast, colorectal, and cervical cancer screening are widely recommended. Lung cancer screening among smokers is also becoming very routine right now. So screening and prevention, of course, along with all the improvements that people have made in treating cancer, they've made a sizable dent in both the incidence of the disease, the number of diagnoses, and deaths from the disease. So the rate of cancer diagnosis has fallen from a peak of about 500,000 people in 1991 in the U.S., to about 450,000 in 2017. So that's a pretty sizable drop. Unfortunately, that drop is mostly driven by the drop in rates among men; women's rates have have not declined the way we would hope. But it's important to note that screening has has played a big role there.

Now, it's always good to be thinking about cancer screenings. But certainly, there's a lot of concern lately because a lot of folks have skipped their routine screenings because of concerns over the coronavirus and also because of financial hardships that make it hard to pay the copay and get in to make the visit. So how has this pandemic impacted cancer screenings?

Well, unfortunately, it's led many people to avoid routine screening, especially for cancer. This is driven in part by expert recommendations — but also, as you mentioned, a reluctance on the part of people to visit a doctor due to potential exposure. Now, people who have health insurance don't have any copays, so it's not a concern for them. But many people don't have insurance, and so they have to bear the cost. And so costs can also drive that, especially when people are out of work. So these factors have affected all screening procedures. So delaying the diagnosis of cancer has real consequences for people's lives. And we haven't had any reliable data published since the middle of 2020. So it'll be interesting to see if the rebound that we're seeing back in July of 2020 was sustained through the pandemic wave at the end of 2020 where, as we all know, the rate of disease diagnoses and deaths shot way up through October, November, December, and January.

But I think it's important listeners should be aware that for colorectal cancer screening, it can be performed at home using stool base tests such as fecal immunochemical test or the stool DNA test. People can do these tests at home, they can be mailed the kits, and then only if that test is positive, do they then have to have a colonoscopy and visit a doctor. This would allow a lot of people to be screened without ever having to expose themselves to the risk of a visit to the doctor's office.

For folks who have really not thought about cancer screenings at all before, do you have any sort of good landmarks of what age you should start thinking about it and perhaps by gender, what what cancers you should be getting screened for?

Well, I always first of all recommend that people talk to their physicians. For colorectal cancer screening, it's now recommended that people over the age of 45 begin screening it, and that can be colonoscopy stool base tests; and then for breast cancer, women 40 and above should talk to their physicians and begin screening at that time; and then for cervical cancer, young adults 25 and above should talk to their physicians about getting screened. A primary method recommended these days is HPV screening, but there's also the traditional pap smear which can be done. You know, for colorectal cancer screening the colonoscopies are done every 10 years or the stool tests are done every year or every three years depending on which type you use for demography pretty much every year; and then for the cervical cancer screening for the HPV test is every five years and for the past year it's every three years.

Outside of these screenings, are there any best practices to try to limit the possibility of getting cancer as far as dietary or lifestyle habits?

Yeah, we haven't found any magic bullets for dietary, but it's generally true that the same things that prevent you from getting things like heart disease probably also reduce your chances for getting cance. So that's exercise regularly. You don't have to be a marathoner, but exercise for 30 minutes a day for at least three days a week. You know, healthy diet. You know, fruits and vegetables. As much as you eat meat or potatoes, try and limit high-temperature cooked meat to an occasional treat rather than eating out every day, and don't smoke. That's perhaps the most important thing for cancer prevention: do not smoke, and then alcohol in moderation because that can cause esophageal and other types of cancer.

Those are all good recommendations for remaining healthy in general, you know, you should do it for all those reasons, not just for cancer prevention, but if you do do it you'll reduce your risk for for getting cancer.


Wellness Wednesday is hosted by Jill Riley, and produced by Anna Weggel and Jay Gabler. Our theme music is a portion of the song "F.B. One Number 2" by Christian Bjoerklund under the Non Commercial Share Alike 3.0 International License.


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