Medical Q&As

Cancer risk - health checks?

My wife's mother passed away ten years ago from cancer of the intestine, which spread to the rest of her body. She was in her early fifties. My wife has got a number of smear tests done but not in the last two years. My wife is 35 so I wonder how often she should get a smear test done? Also are there other precautions or tests she should be taking regularly?

Your question refers to two different forms of cancer, which are not linked. Intestinal and cervical cancer arise through completely different disease mechanisms therefore your mother-in-law’s history of carcinoma of the intestine does not increase the probability of your wife developing carcinoma of the cervix. Your wife does not have to increase her frequency of attendance for smear testing because her mother died of intestinal cancer. You might find it helpful to read two linked articles that I have written on the subject of carcinoma of the cervix. The first article explains the process of smear testing and can be accessed at: http://www.irishhealth.com/index.html?level=4&id=2928. The second article explains the meaning of the test results and can be accessed at: http://www.irishhealth.com/index.html?level=4&id=3044. I have also written an article that questions if all screening for disease is justified and that can be read at: http://www.irishhealth.com/index.html?level=4&id=1657. I realise that the response I have given has loaded you with homework but the questions you raise are not as straightforward as they appear. Your question raises philosophical questions about the ethics of screening. There is a limited amount of evidence to justify screening for a small number of diseases. It could be argued that it would be appropriate for your wife to be screened for intestinal cancer but then the question arises as to which test should be performed and at what intervals should it be repeated. Perhaps she would be reassured by undergoing a colonoscopy to establish if her bowel is normal. Alternatively the prospect of having that test could raise great fears for her. One of my concerns about screening is that it can create a fear of disease in people who are well. If people are to be offered screening tests then that test better be accurate, reliable and come with a guarantee that if the person goes through the process that it will make a positive difference. Your wife should continue with screening for cervical cancer. The evidence is there to justify such screening. It is certainly not necessary for her to increase the frequency of such testing. The other question regarding regular health checks is highly debatable and not at all proven.