Timetables for Cancer Checks

Aside from prevention, early detection of cancer is the most effective way of fighting it. Last week, citing studies on the costs, risks and benefits of screening tests, as well as new information about how the disease develops, the American Cancer Society announced major changes in its cancer checkup recommendations to the public. Among them:

> For women between 20 and 65 (and those under 20 who are sexually active), the Pap test for cervical cancer need be done only once every three years (after two negative tests a year apart), instead of once a year.

> Women should have breast X rays, which previously were not recommended at all, once between 35 and 40 to establish a reference, then at the advice of a physician until 50, and every year after 50. Women should continue to give themselves breast examinations each month.

> Annual chest X rays, recommended in the past for early detection of lung cancer in smokers and others at high risk, are no longer deemed necessary. Nor is sputum cytology, an analysis of lung cells contained in sputum. One reason: lung cancer is still so resistant to cure as to make early detection useless and a waste of money. Rather, prevention, especially by avoiding smoking, should be emphasized.

> Examination of the rectum and colon with a sigmoidoscope, previously called for annually for people over 40, is now suggested every three to five years (after two negative tests a year apart) in those over 50. The A.C.S. recommendation for digital rectal examinations every year from age 40 on remains unchanged.

> The age at which to begin having annual guaiac slide tests on stool to detect intestinal bleeding has been raised from 40 to 50.

> Instead of a "periodic" (usually interpreted to mean once a year) general checkup for cancer, including physical examination of the breasts and pelvis, testicles and prostate, thyroid, lymph nodes, mouth and skin, the A.C.S. now suggests one every three years between ages 20 and 40, and annually thereafter.

In making the new recommendations, the A.C.S. emphasized that they were merely general guidelines and that people should continue to rely on the advice of their own doctors.

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