Nursing Care of the Postmenopausal Woman, 3rd Edition
288
are 20% more likely to test positive for colorectal cancer and are 40% more likely to die from the disease. The rate of col- orectal cancer is higher in this community than any other community in the U.S. This difference is most likely due to increased risk factors such as a diet that includes more animal fat and less fiber, higher to - bacco use, obesity, less physical activity and lower vitamin intake, and increased difficulty accessing healthcare. The Amer - ican Cancer Society recommends that Af- rican Americans with average risk begin regular screening for colorectal cancer at age 45. People at higher risk should de- velop a screening plan with their health- care provider (ACS, 2020d; American Society of Colon and Rectal Surgery [AS- CRS], 2019). Ovarian cancer diagnostic testing At this time, there is no reliable meth- od to screen for ovarian cancer (Ameri- can Cancer Society [ACS], 2020cb). Early symptoms of ovarian cancer should be explained to all women: Bloating, abdom- inal or pelvic pain, trouble eating or feel- ing full too quickly, and urinary symptoms such as urgency and frequency. Any wom- en with these symptoms should be evalu- ated for ovarian cancer (ACS, 2020c). The importance of taking a thorough family history to identify higher risk individuals, a full health history and current review of systems, and recognition of the signs and symptoms that would necessitate a pelvic exam cannot be overstated; however, the USPSTF recommends against screening for ovarian cancer in asymptomatic wom- en (USPSTF, 2018d). There are several methods of imag- ing to assist in the diagnosis of ovarian cancer. A transvaginal ultrasound can be used to evaluate any abnormal findings on the ovaries; however, this is not a rou- tine screening test and ultrasound has
limitations. It can determine if a tumor is present, how large it is, if the mass is solid or filled with fluid, and how com - plex the mass is (ACS, 2020c). It cannot differentiate, however, among cancer and other issues. If needed, a computerized tomography (CT) scan of the abdomen can also be performed. However, this is not recommended as routine screen- ing either. An abdominal CT will give a cross-sectional image of the mass. CT scans are usually done before and during needle biopsies. Other imaging tests are magnetic resonance imaging (MRI), chest x-ray, and positron emission tomography (PET) scans (ACS, 2020c). The CA-125 blood test checks for a protein in the blood that can be elevat- ed in women with ovarian cancer. This test can have a high false- positive rate. A false-positive test can be caused by other types of cancer, endometriosis, early pregnancy, abnormal pregnancy, and intrauterine fetal death. Neither the transvaginal ultrasound nor the CA-125 test is currently recommended for rou- tine screening. Women who have a family history of ovarian cancer are offered ei- ther or both tests annually (ACS, 2020c; USPSTF, 2018c). | NURSING CONSIDERATION Because there is no screening method for ovarian cancer, it is critical that nurses be well versed on the early signs and symptoms of the disease. Women should be educated to report any bloating, abdominal or pelvic pain, trouble eating or feeling full too quickly, and urinary symptoms such as urgency and frequency to their healthcare provider to ensure early intervention and testing.
Powered by FlippingBook