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Cancers that strike women: Curbing your risk

When was the last time you had a Pap smear? Do you smoke? Do you get any exercise? How many alcoholic beverages a day, if any, do you drink?

The answers to these and other questions may reveal if you are at risk for the cancers that strike women. Read on to learn more about where you stand and what measures you can take to keep your personal risk in check. (Keep in mind, too, that lung cancer is the number one cancer killer of women.)

Breast cancer

More than 182,000 American women develop breast cancer each year, and more than 40,000 succumb to the disease. Yet much can be done to detect breast cancer early, and mounting evidence suggests that certain lifestyle habits, such as regular physical activity and limited use of alcohol, may help prevent the disease.

Risk factors:

  • increasing age
  • genetic mutations in the BRCA1 and BRCA2 genes
  • a family history of breast cancer
  • early onset of menstruation (before age 12)
  • late menopause (after age 50)
  • never having children or having a first child after age 30
  • obesity after menopause

Factors that may curtail your risk:

  • reaching and maintaining an ideal weight
  • eating a low-fat, high-fiber diet
  • limiting alcoholic beverages to one a day
  • engaging in moderate physical activity
  • quitting tobacco use
  • discussing the benefits and risks of menopausal hormone therapy and the drugs tamoxifen and raloxifene with your physician

Screening recommendations:

  • Get a baseline mammogram by age 40, every one to two years during your 40s, then annually after age 50.
  • Get an annual magnetic resonance imaging scan along with a mammogram beginning at age 30 if you have the BRCA1 or BRCA2 mutations or other risk factors.
  • Get a clinical breast exam every three years between ages 20 and 39, then every year after.
  • Optional: Perform breast self-examinations monthly beginning at age 20.

Ovarian cancer

More than 21,000 women are expected to develop ovarian cancer this year [2008] in the United States. Largely because it is difficult to detect in its early stages, ovarian cancer causes more deaths than any other cancer of the female reproductive system. In women over age 40, a bloated abdomen and vague, unexplained stomach discomfort are reason to see a physician. (These symptoms may also be caused by irritable bowel syndrome or other gastrointestinal disorders.)

Risk factors:

  • increasing age
  • never having children
  • a family history of ovarian cancer
  • a personal or family history of breast or colon cancer
  • a history of difficulty getting pregnant
  • genetic mutations in the BRCA1 and BRCA2 genes

Factors that may curtail your risk:

  • having children
  • breastfeeding

Screening recommendations:

  • Get a thorough pelvic exam regularly starting at age 18, and then according to your doctor’s recommendations.
  • Report unexplainable indigestion, gas or bloating; swelling or pain in the abdomen; and pain during intercourse. Your physician may recommend additional tests to detect early-stage tumors.

Cervical cancer

There’s plenty of good news in the war against cervical cancer. Although it strikes about 11,000 women in the United States each year, incidence of this slow-growing cancer has been decreasing steadily over the past several decades. What’s more, the Pap smear has caused a great decrease in the number of deaths from this disease in the past 40 years. A new vaccine is available to protect against the types of HPV (human papillomavirus, a sexually transmitted disease) most likely to cause cervical cancer.

Risk factors:

  • infection with HPV
  • smoking

Factors that may curtail your risk:

  • quitting tobacco use
  • practicing safe sex
  • HPV vaccination

Screening recommendations:

  • Get a regular Pap smear beginning at age 18. The Pap test can detect HPV infection and precancerous conditions that lead to cervical cancer. Treatment of these problems can decrease the risk of developing cervical cancer.
  • Notify your gynecologist of any unusual vaginal discharge, abnormal vaginal bleeding or spotting, or bleeding or pain during intercourse.

Endometrial cancer

About 40,000 women in the United States were diagnosed with endometrial cancer (cancer of the uterine lining) last year. Although it is the most common cancer of the female reproductive system, it is also the most treatable. Estrogen is the major risk factor for this type of cancer, so anything that prolongs a woman’s exposure to the hormone increases her chance of developing the disease.

Risk factors:

  • early onset of menstruation (before age 12)
  • late menopause (after age 50)
  • never having children or a history of failure to ovulate
  • use of estrogen therapy without the addition of progesterone
  • being obese
  • a family history of endometrial cancer

Factors that may curtail risk:

  • having children
  • reaching and maintaining a healthy weight
  • combining progesterone with estrogen in menopausal hormone therapy

Screening recommendations:

  • Get an annual pelvic exam.
  • Report any abnormal bleeding to your physician as soon as possible. Abnormal bleeding is usually the earliest symptom of endometrial cancer. If you’re premenopausal, any bleeding that occurs between periods or unusually heavy periods are considered abnormal. After menopause, any vaginal bleeding—other than that caused by hormone therapy—is abnormal. If you’re approaching “the change,” be careful not to mistake abnormal bleeding as a sign of menopause. Abnormal bleeding may appear as a pink, watery discharge or be similar to menstrual bleeding.
  • Women at high risk for the disease may be screened with endometrial biopsy at menopause and periodically thereafter.

Breast cancer

Ovarian cancer

Cervical cancer

Endometrial cancer