Mammograms are the best way to find breast cancer early, when it is easier to treat. Even so, mammograms do not detect all breast cancers. Some breast lesions and abnormalities are not visible or are difficult to interpret on mammograms. Breasts that are considered dense have a lot of glandular and connective tissues and not much fatty tissue, and that makes cancer harder to detect.

Supplemental Breast Cancer Screening:

Breast ultrasound is primarily used to help diagnose breast lumps or other abnormalities found during a physical exam or mammogram. Ultrasound is safe, noninvasive and does not use radiation.

Ultrasound can be offered as a screening tool for women who:

• are at high risk for breast cancer and unable to undergo an MRI examination.
• are pregnant or should not be exposed to x-rays (which are necessary for a mammogram).
• have increased breast density

Breast Cancer Screening Guidelines for Women

The Pap test can find abnormal cells in the cervix which may turn into cancer. Our Centre does the liquid-based cytology Pap test which is significantly more e"ective than the conventional smear method. Clinical trials demonstrated that the test improved the detection of low-grade and more severe lesions by 65% and reduced the number of less than adequate specimens by more than 50%.²

Pap smear screening should start at age 21³. After the first test:

• Women ages 21 through 65 should be screened with a Pap smear every 3 years. If your Pap test result is normal, your doctor may tell you that you can wait three years until your next Pap test.
• Women ages 65 through 70 can stop having Pap smears as long as they have had 3 normal tests within the past 10 years.
• Women who have been treated for precancer (cervical dysplasia) should continue to have Pap smears for 20 years after treatment or until age 65, whichever is longer.

Colorectal cancer is the most common cancer in men (16.4%) and second most common in women (10.7%) after breast cancer in Malaysia. It almost always develops from precancerous polyps (abnormal growths) in the colon or rectum. Screening tests can find precancerous polyps, so they can be removed before they turn into cancer. Screening tests also can find colorectal cancer early, when treatment works best.

You should begin screening for colorectal cancer soon after turning 50, then continue getting screened at regular intervals. However, you may need to be tested earlier than 50, or more often than other people, if—

• You or a close relative have had colorectal polyps or colorectal cancer.
• You have an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
• You have a genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome).

Lung cancer is the second most common cancer among males (15.8%) and fifth among females (5.6%) in Malaysia. The incidence increases with age. Lung cancer causes more deaths in Malaysian males than any other cancer and is the second cause of cancer deaths in Malaysian females after breast cancer.

Lung cancer is more successfully treated when diagnosed at an early stage. The goal of lung cancer screening is to detect lung cancer at a very early stage - when it is more likely to be cured.

Results of the very large, randomized, population-based NELSON trial confirm the value of low-dose computed tomography (CT) screening in people at high risk for developing lung cancer. The protective value of screening was more pronounced in women than in men. These study findings were presented at the International Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer. Overall, CT scanning decreased mortality by 26% in high-risk men and up to 61% in high-risk women over a 10-year period.

SJMC’s high-performance, dual-source CT scanner o"ers a technology (1st in Malaysia) that helps enable CT scans to be performed at an extremely low radiation dose, at as low as 15 Chest X-Rays (CXR) (standard average – 100 CXR), which could prove beneficial for lung cancer screening. The CT scanner’s ultra-fast scanning speed does not compromise diagnostic imaging quality and enables precise diagnostics with reduced contrast dose.

General Screening Profile (GSP) - Regular comprises a set of approximately 50 blood and urine tests categorized under Clinical Chemistry, Haematology, Blood Serology and Urinalysis respectively. You will need to fast at least 10 hours prior to the day of screening but plain water can be consumed.

CLINICAL CHEMISTRY

HAEMATOLOGY

Ultrasound is safe, noninvasive and does not use ionizing radiation.

Ultrasound imaging of the abdomen is used to help diagnose distention (enlargement) of the structures within the upper abdomen and evaluate the kidneys, liver, gallbladder, bile ducts, pancreas, spleen and abdominal aorta. Similarly, like the GSP, you should refrain from eating beforehand. Wear loose, comfortable clothing as you may be asked to wear a gown.

There are three types of pelvic ultrasound: abdominal, vaginal (for women), and rectal (for men). These exams are frequently used to evaluate the repro- ductive and urinary systems.

Drink plenty of water prior to the examination to fill your bladder for better ultrasound image clarity. Wear loose, comfortable clothing as you may be asked to wear a gown.

Chest x-ray uses a very small dose of ionizing radiation to produce pictures of your lungs, heart, bones of the spine and chest. It may be used to help diag- nose shortness of breath, persistent cough, fever, chest pain or injury. Tell the radiographer if there is a possibility you are pregnant.

Bone Mineral Density Scan (BMD 2-Parts : Hip & Spine Lumbar)

Bone density scan is a special type of X-ray that measures bone mineral densi- ty (BMD). It provides information about bone strength or fragility and the risk of fractures or broken bones. The higher the density, generally, the lower the risk of fracture. The BMD at the hip and spine has been shown to be the best way of predicting the risk of fracture.

The scan does involve a very small dose of radiation, which makes this test unsuitable for women who are, or might be, pregnant. If you have had spinal surgery, particularly with metallic implants, or hip surgery (hip replacements, screws or pins) you will need to inform the radiographer carrying out the scan. Any radiological investigation using contrast media (Barium enemas, Intrave- nous pyelograms and CT scans) or nuclear medicine test might interfere with the accuracy of the BMD scan if carried out within the last week.

Recent evidence suggests that healthy women 67 years and older with normal bone mass may not need to be rescreened for up to 10 years provided osteo- porosis risk factors do not significantly change.

Treadmill Stress Test

Stress testing provides information about how your heart works during physical stress. Some heart problems are easier to diagnose when your heart is working hard and beating fast. During stress testing, you exercise (walk or run on a treadmill) to make your heart work hard and beat fast. Tests are done on your heart while you exercise.

Tumour Markers

Tumour markers are substances that are produced by cancer or by other cells of the body in response to cancer or certain benign (noncancerous) conditions. They are produced at much higher levels in cancerous conditions. Some are associated with only one type of cancer, whereas others are associated with two or more cancer types. E.g. CEA, AFP, PSA, CA 19-9, CA 15-3, CA 125. No “universal” tumour marker that can detect any type of cancer has been found.

Sometimes, noncancerous conditions can cause the levels of certain tumour markers to increase. In addition, not everyone with a particular type of cancer will have a higher level of a tumour marker associated with that cancer. Moreover, tumour markers have not been identified for every type of cancer.

Thyroid Function Test

The blood test for thyroid problems is called a Thyroid Function Test. The most usual tests are:

• Thyroid Stimulating Hormone (TSH)
• Free T4 (FT4)
• Free T3 (FT3)

Rheumatoid Factor (RF)

This blood test helps diagnose the presence of an autoimmune disease such as rheumatoid arthiritis (RA)

Nutritional Assessment (with Body Composition Analysis)

The body composition analysis will comprise measurements of weight, height, lean body mass, soft lean mass, total body water, body mass index (BMI), percent body fat, visceral fat, fat mass, basal metabolic rate, total energy expenditure, and age matched of body, among others.

Dental Screening

This includes a dental X-ray and consultation with the dentist. Dental screening is outsourced to an established dental practice.

Vaccination is Protection

Vaccines work to protect individuals, families and communities against 26 diseases and illnesses including influenza⁴.

Our Vaxin Center™ o"ers ADULT vaccinations from age 18 and above; for HPV vaccinations (age 13 to 45). We are also a Ministry of Health-certified Yellow Fever Vaccination Centre.

All our adult vaccinations are competitively priced. Please contact us for your vaccination needs.