Why do some people test "normal" in physical exams but are later diagnosed with cancer? Why are many cancers detected only at advanced stages? These real-life cases serve as a stark reminder.
A clean bill of health ≠ Lifetime immunity
Routine checkups ≠ Cancer screening
•Routine Health Checkups
Focus on basic indicators such as blood/urine tests, liver/kidney function, blood pressure, lipids, blood glucose, ECG, and B-scan Ultrasonography. These primarily assess overall health status of the examinee.
•Cancer Screening
Cancer screening emphasizes precision, targeting high-risk groups and specific cancer types to detect early signs of malignancy and address potential risks through timely intervention.
Dr. Jin Hong, Director of the Health Examination Center at Hainan Chengmei Hospital, cautions that not everyone requires cancer screening. Personalized screening plans should be tailored for high-risk individuals based on the following factors:
Age:≥40 years without regular lung, breast, or other cancer screenings; ≥25 years without cervical cancer screening.
Unhealthy lifestyle habits: Long-term smoking or exposure to secondhand smoke; Heavy alcohol consumption; High intake of salty, preserved foods, or preference for red meat.
Obesity: BMI ≥28 kg/㎡.
Family history of cancer or genetic predisposition.
Unexplained symptoms: Weight loss, altered bowel habits, hemoptysis, or breathing difficulties.
Occupational exposure: Long-term contact with harmful chemicals or radiation.
Hainan’s Top 10 High-Incidence Cancers and Their Screening "Gold Standards"
During the 31st National Cancer Prevention Awareness Week, China released the 2025 Recommendations for Common Malignancy Screening and Prevention, outlining the high-risk groups and "gold standards" for over 20 cancers.
According to the latest Hainan Cancer Registry Annual Report, approximately 23,000 new cancer cases are diagnosed annually in Hainan. The top 10 malignancies are: Lung cancer, Liver cancer, Colorectal cancer, Breast cancer, Cervical cancer, Gastric cancer, Endometrial cancer, Esophageal cancer, Nasopharyngeal cancer, Oral cancer.
Below are the screening "gold standards" for these cancers:
Tip 01: Lung Cancer
I. High-risk groups:
•≥40 years with ≥20 year smoking history (including those who quit <15 years ago);
•Passive smokers(secondhand smoke);
•Occupational exposure (e.g., asbestos, beryllium, uranium, radon);
•Chronic lung diseases or family history of lung cancer.
II. Gold standard screening and recommendations:
Low-dose spiral CT (LDCT). High-risk individuals should undergo LDCT screening using 64-slice or higher multislice spiral CT.
Tip 02: Liver Cancer
I. High-risk groups:
•Men ≥35 years; women ≥45 years;
•Chronic HBV/HCV infected individuals;
•Patients with family history of liver cancer or cirrhosis;
•Patients with nonalcoholic fatty liver disease.
II. Gold standard screening and recommendations:
Serum AFP + Liver ultrasound. It is recommended that high-risk individuals for liver cancer - males aged 35 and above, and females aged 45 and above - undergo screening every 6 months.
Tip 03: Colorectal Cancer
I. High-risk groups:
•Individuals ≥45 years;
•Those with a family history of colorectal cancer;
•Patients with chronic ulcerative colitis;
•Postoperative colorectal cancer patients or those with a history of colorectal adenoma treatment.
II. Gold standard screening and recommendations:
Colonoscopy. Screening options: Annual fecal immunochemical test (FIT), multi-target FIT-DNA test every 1–3 years, or blood-based tumor DNA test every 1–3 years. Positive results require immediate colonoscopy. Alternatively, colonoscopy every 5–10 years until age 75. Healthy individuals aged 76–85 with ≥10-year life expectancy may continue screening; those ≥85 years are not recommended for further screening.
Tip 04: Breast Cancer
I. High-risk groups:
•Women ≥40 years;
•Those with a family history of breast cancer;
•Women carrying BRCA1/BRCA2 gene mutations;
•Individuals who received chest radiation before age 30.
II. Gold standard screening and recommendations:
Mammography. Begin screening at age 40, every 1–2 years. For dense breasts, combine with ultrasound. Healthy individuals ≥70 years with ≥10-year life expectancy should continue screening every 1–2 years.
Tip 05: Cervical Cancer
I. High-risk groups:
•Multiple sexual partners or early sexual activity;
•HPV-infected individuals;
•Immunocompromised individuals or those with a history of cervical lesions.
II. Gold standard screening and recommendations:
Pap smear + HPV co-testing. Ages 21–29: Pap smear every 3 years after 3 consecutive normal results. Ages 30–65: Pap smear every 3 years or co-testing every 5 years after normal results.
Tip 06: Gastric Cancer
I. High-risk groups:
•≥45 years from high-risk regions;
•Patients with moderate-to-severe atrophic gastritis, gastric ulcers, or polyps;
•H. pylori infected individuals;
•Those with a family history of gastric cancer.
II. Gold standard screening and recommendations:
Gastroscopy. High-risk individuals ≥45 years should undergo regular gastroscopy as advised by physicians.
Tip 07: Endometrial Cancer
I. High-risk groups:
•Postmenopausal women ≥50 years;
•Prolonged estrogen exposure (e.g., PCOS, early menarche, or late menopause);
•Nulliparity or type 2 diabetes.
II. Gold standard screening and recommendations:
Pelvic ultrasound + Endometrial biopsy. High-risk groups should undergo regular gynecological exams.
Tip 08: Esophageal Cancer
I. High-risk groups:
•≥40 years from high-risk regions;
•Those with a family history of esophageal cancer or precancerous lesions;
•Smokers, heavy drinkers and people who like hot food.
II. Gold standard screening and recommendations:
Endoscopy. High-risk groups should undergo endoscopy every 2 years. If mild dysplasia is detected, annual endoscopy is recommended.
Tip 09: Nasopharyngeal Cancer
I. High-risk groups:
•EBV infected individuals;
•First-degree relatives with nasopharyngeal cancer;
•Long-term residency in high-risk regions (e.g., southern China).
II. Gold standard screening and recommendations:
EBV antibody testing + Nasopharyngoscopy + MRI. High-risk individuals should begin screening at age 30.
Tip 10: Oral Cancer
I. High-risk groups:
•Long-term smokers, drinkers or betel nut chewers;
•Those with a history of oral mucosal diseases or poor oral hygiene;
•People with chronic vitamin A deficiency.
II. Gold standard screening and recommendations:
Clinical oral exam + Biopsy. General population: 2–4 clinical oral exams annually; High-risk groups: Add lab tests and imaging, biopsy if necessary for diagnosis.
Expert Reminder
Jin Hong emphasizes that cancer screening is a tool for early detection. While it cannot prevent cancer entirely, early intervention significantly improves cure rates. Screening choices should align with individual health profiles and risk factors.
Edited by: Huang Fei