Cancer is one of the leading causes of death worldwide. Early detection and diagnosis plays a vital role in the successful treatment of cancer. Advances in diagnostic technologies have improved our ability to accurately detect and diagnose different types of cancers at early stages. However, for many people cancer diagnosis still remains a complex and confusing process. This article aims to provide a comprehensive overview of the various diagnostic tests and procedures that are commonly used to detect and diagnose cancer.

Screening Tests

Screening tests are performed when a person has no symptoms. The purpose is to detect cancer at an early stage, before symptoms appear. Some of the common screening tests for different types of cancers include:

- Mammography: It is the most common screening test for breast cancer. Low-dose x-rays of the breast are used to detect tumors that may be non-palpable or too small to see or feel. Mammograms can detect breast cancers up to two years before they can be felt.

- Pap test: It is used for screening cervical cancer. Cells are collected from the cervix and vagina and examined under a microscope. Abnormal cells can indicate infection with HPV or early signs of cancer.

- Fecal occult blood test (FOBT): This non-invasive home test checks for hidden (occult) blood in the stool, which can be an early sign of colorectal cancer. A positive FOBT result often leads to colonoscopy for further investigation.

- Low-dose CT scan: Also known as low-dose helical or spiral CT, it plays an important role in lung cancer screening and is used to detect early-stage lung cancers in high-risk individuals like heavy smokers.

Diagnostic Imaging Tests

When a screening test detects an abnormality or a person experiences cancer symptoms, further diagnostic tests are required for confirmation of diagnosis. Medical imaging tests provide vital information about the size, location and spread of tumors. Some commonly used diagnostic imaging tests include:

- Ultrasound: It uses high-frequency sound waves to produce images of internal organs. Ultrasound scans are safe, painless and do not use ionizing radiation. It is useful for imaging breasts, thyroid, abdominal organs and other internal structures.

- MRI (Magnetic Resonance Imaging): With the use of strong magnetic fields and radio waves, MRI produces very detailed images of organs and soft tissues in the body. It is particularly useful for imaging the brain and spinal cord.

- CT (Computed Tomography) scan: Also known as CAT scan, it uses X-rays to generate cross-sectional images or slices of the body. A contrast dye may be injected to provide better detail. CT scans are commonly used to diagnose lung, liver, chest and abdominal cancers.

- PET (Positron Emission Tomography) scan: A PET scan combined with a CT scan, called a PET-CT scan, provides both anatomic and metabolic information and has become an important tool for cancer diagnosis, staging and monitoring treatment response.

Biopsy

When imaging or other diagnostic tests show an abnormal area, a biopsy is usually required to confirm or rule out cancer. During a biopsy, a sample of suspicious tissue is removed from the body and examined under a microscope by a pathologist. The main types of biopsies include:

- Needle biopsy: A hollow needle is used to remove cells or tissue samples. Types include fine needle aspiration (FNA) biopsy and core needle biopsy.

- Surgical biopsy: An incision or cut is made to remove the entire lump or a sample of tissue. Common surgical biopsies are lumpectomy and lymph node biopsy.

- Endoscopic biopsy: A thin, lighted tube (endoscope) is inserted through a body opening to visually examine organs and take tissue samples.

Blood and Other Fluid Tests

Certain blood and fluid tests play an important role in Cancer Diagnostics:

- Complete blood count (CBC): It checks cancer-related changes in different types of blood cells.

- Tumor markers: These are substances often found at higher-than-normal levels in the blood, urine, or body tissues of some cancer patients. Commonly tested tumor markers include CEA, CA125, CA 19-9, PSA, and AFP.

- Genetic tests: Testing for genetic mutations known to increase cancer risk help determine the chances of developing certain cancers like BRCA1 and BRCA2 genes linked to breast and ovarian cancer.

Staging and Molecular Testing

Once cancer is detected and diagnosed, doctors determine its stage. The stage provides vital information about how far the cancer has spread and helps decide the most effective treatment. Cancer staging involves additional tests like MRI/CT scans, chest X-rays, biopsies and/or surgery. Molecular testing aims to analyze the genetic profile of cancer cells to select targeted therapies.

With the latest diagnostic tools and technologies, doctors can now detect cancer at its earliest stages. An appropriate diagnostic workup involving screening, imaging, biopsies and other lab tests helps accurately diagnose the type and extent of cancer. Future advances will lead to even earlier cancer detection and more precise diagnosis for improving patient outcomes.

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