Health Advice



The pandemic has disrupted preventive health care. Here's how to get back on track

Marie McCullough, The Philadelphia Inquirer on

Published in Health & Fitness

No one wants a colonoscopy, but this screening test truly prevents colorectal cancer because the physician can find and remove precancerous polyps.

A first colonoscopy is now recommended at age 45, instead of 50, because colorectal cancer has been increasing among younger adults, especially in Black patients. “We definitely want to make sure people are getting colonoscopies,” Wardlaw said.

The interval for a repeat colonoscopy varies, depending on risk factors and the results of the first screen.

If you’re at average risk, stool tests are at-home alternatives for screening, but positive results mean you need a colonoscopy.

For women, breast and cervical cancer screening guidelines have evolved. Leading organizations say that average-risk women age 55 and older can get mammograms every two years, rather than annually, if results show no evidence of cancer. So you may be within the recommended interval, even if you skipped your mammogram last year.

Pap smears, which used to be done annually, are no longer recommended more often than every three years. And if you add a screening test for HPV, the virus that causes cervical cancer, you can wait five years after normal results to screen again.


Prostate cancer screening advice has also changed. Men should talk to their doctors about the pros and cons of routine PSA blood tests. For higher risk men — that includes Black men — screening may be prudent. But experts say the risks of detecting and treating an inconsequential tumor should be discussed.

Skin cancer — including melanoma, the most dangerous kind — is linked to sun (and sunlamp) exposure, skin type and age. If you are fair skinned or have been treated for basal or squamous cell skin cancer, monthly self-checks and annual checks by a physician are a good idea. Rates of all types of skin cancer have been rising for 30 years.

For that JAMA Network study of the decline in cancer diagnoses, researchers from Quest Diagnostics used records of newly diagnosed cancer patients who received testing at Quest. In the year before the pandemic hit, the monthly average of new diagnoses was 32,000. In the most recent period, November 2020 to March 2021, the monthly average was about 26,000 — suggesting thousands of people skipped screening tests or checkups in the last year.



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