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Screening and prevention

Many cancers can be prevented, and most can be treated far better when found early. Who should be checked, how, the warning signs not to ignore, and how to lower the risk - from the World Health Organization, the US Preventive Services Task Force and national programmes such as India's. What is offered free differs by country; ask your doctor what applies where you live.

A warning sign is not a diagnosis โ€” but it needs a doctor soon. Free screening for oral, breast and cervical cancer is offered from age 30 at government Ayushman Arogya Mandir centres.

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Oral cancer

Who: Everyone aged 30 and over - especially anyone who uses tobacco in any form, areca nut (supari, gutka, paan) or alcohol.

How

  • A doctor or trained health worker looks inside the mouth. It takes two minutes and is offered free at government Ayushman Arogya Mandir centres under the national programme for common cancers.
  • Check your own mouth once a month in a mirror.

Warning signs

  • A white or red patch that does not go away
  • A mouth ulcer that has not healed in two weeks
  • A lump, or a thickening of the cheek
  • Difficulty opening the mouth, chewing or swallowing

Lower the risk

  • Stop all tobacco and areca nut - the National Tobacco Quitline is free: 1800-112-356
  • Limit alcohol
  • Eat plenty of fruit and vegetables
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Cervical cancer

Who: Girls aged 9-14 for the HPV vaccine; women aged 30-65 for screening.

How

  • HPV vaccine before the start of sexual life - India makes its own (Cervavac).
  • Screening every 5 years from age 30: a simple visual test (VIA) under the national programme, or an HPV test where it is offered (the World Health Organization prefers HPV testing).

Warning signs

  • Bleeding after sex, between periods or after the menopause
  • Unusual or foul-smelling discharge
  • Pain in the pelvis

Lower the risk

  • HPV vaccination
  • Regular screening
  • Do not smoke
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Breast cancer

Who: All women aged 30 and over; earlier and more often for women with a strong family history.

How

  • A clinical breast examination by a trained health worker or doctor, offered under the national programme for women aged 30-65.
  • Ask your doctor whether and when you need a mammogram.
  • A close family history (mother, sister, daughter) or a known BRCA change: ask about genetic counselling.

Warning signs

  • A new lump in the breast or armpit
  • Dimpling or puckering of the skin
  • A nipple that turns inward, or discharge (especially blood)
  • A change in the size or shape of a breast

Lower the risk

  • Stay active and at a healthy weight
  • Limit alcohol
  • Breastfeeding lowers the risk
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Lung cancer

Who: People aged 50-80 who smoke heavily or did (a "20 pack-year" history), or who quit within the last 15 years.

How

  • A yearly low-dose CT scan is recommended for this group in the USA. India has no national lung screening yet - ask your doctor.
  • A cough that lasts more than 3 weeks needs a doctor: it can be TB or cancer.

Warning signs

  • A cough that will not go away, or coughing blood
  • Breathlessness or chest pain
  • Weight loss without trying

Lower the risk

  • Stop smoking - it is never too late
  • Avoid second-hand smoke and indoor smoke from solid fuel
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Bowel (colorectal) cancer

Who: Adults aged 45-75 (the US recommendation); anyone with symptoms or a family history.

How

  • A stool test for hidden blood, or a colonoscopy - ask your doctor which suits you.

Warning signs

  • Blood in the stool
  • A change in bowel habits that lasts weeks
  • Unexplained anaemia or weight loss

Lower the risk

  • Eat fibre, fruit and vegetables; less red and processed meat
  • Stay active
  • Do not smoke
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Prostate cancer

Who: Men aged 55-69 should talk to their doctor about a PSA blood test.

How

  • The PSA test has benefits and harms; decide together with your doctor.

Warning signs

  • Difficulty passing urine, a weak stream or going often at night
  • Blood in the urine
  • Bone pain

Lower the risk

  • Stay active and at a healthy weight
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Liver cancer

Who: Anyone with hepatitis B or C, or cirrhosis of the liver.

How

  • Hepatitis B vaccination - part of India's free childhood immunisation.
  • A test for hepatitis B and C; people with cirrhosis or hepatitis B may need an ultrasound every 6 months.

Warning signs

  • Pain in the upper right abdomen
  • Yellow eyes or skin
  • Swelling of the abdomen

Lower the risk

  • Hepatitis B vaccine
  • Treat hepatitis B and C
  • Limit alcohol
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Sources

Guidance changes; your doctor knows your own risk
World Health Organization - cancerhttps://www.who.int/health-topics/cancerICMR National Centre for Disease Informatics and Research (India)https://www.ncdirindia.org/US Preventive Services Task Force recommendationshttps://www.uspreventiveservicestaskforce.org/National Tobacco Quitline (India): 1800-112-356https://ntcp.mohfw.gov.in/

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