Ask An Expert: Dr. Yan on Updated Cancer Screening Guidelines, Prevention Strategies, and the Power of Early Detection

In this Q&A, Dr. Fengting Yan, a leading female oncologist at the Swedish Cancer Institute, answers frequently asked questions about cancer prevention and early detection. She discusses updated screening guidelines for women's cancers and comprehensive prevention measures—including HPV vaccinations and lifestyle strategies—to reduce cancer risk. She also emphasizes the importance of ongoing education, multidisciplinary collaboration, and empowering women in oncology. Dr. Yan shares insights on how women can take charge of their health and assume leadership roles in advancing cancer care and research.

Highlights/Takeaways of Q&A

Updated Screening Guidelines: Dr. Yan emphasized that mammogram screenings should begin at age 40, reflecting updated guidelines in response to rising breast cancer rates among women under 50.

Comprehensive Prevention Measures: She highlighted the importance of HPV vaccinations for both girls and boys, along with lifestyle strategies—such as stress management, regular exercise, and a low-fat diet—to reduce cancer risk.

Ongoing Education & Multidisciplinary Collaboration: Dr. Yan underscored the value of continuous medical education, such as the ones offered by Binaytara, multidisciplinary approaches to treatment, and community outreach to enhance early screening and address gender disparities in oncology.

Dr. Fengting Yan is a 2021, 2022, 2023, and 2025 Seattle Met Top Doctor Award winner. Dr. Yan is interested in personalized care and translational research in women’s cancer. As an oncologist at the Swedish Cancer Institute in Seattle, Washington, her primary focus is on women's cancers, including breast, cervical, endometrial, and ovarian cancer. With a background in obstetrics and gynecology (OBGYN), she has always been deeply committed to women's health. Her passion for oncology led her to pursue postdoctoral training in the field, where she developed a strong interest in women's cancers. Today, she is dedicated to providing expert care and advancing research in oncology to improve outcomes for patients facing these diseases. February is National Cancer Prevention Month, and at Binaytara, we had the opportunity to sit down with Dr. Yan to discuss the crucial role of screening and early detection in reducing cancer risk and improving patient outcomes.

Question | Binaytara: What are the top cancer prevention strategies you want everyone to know?

Answer | Dr. Yan: I always give my patients three key recommendations:

• Manage Stress: Chronic stress can contribute to cancer development and weaken the immune system. While we cannot eliminate stress, we can control how we respond to it through activities like counseling, meditation, music therapy, and exercise.
• Exercise Regularly: Studies show that physical activity reduces cancer recurrence and mortality, particularly in breast cancer. I encourage everyone to set aside 30 minutes daily for exercise, not for work or family, but as personal "me time" for overall well-being.

• Follow a Healthy Diet: A low-fat diet, as shown in the Women’s Health Initiative trial, reduced breast cancer mortality risk by 21%. Long-term dietary changes, such as reducing red meat for colon cancer prevention and prioritizing whole foods over supplements, support overall health.

Q: Could you elaborate on your efforts engaging with referring physicians in the community, particularly regarding improving early detection and prevention strategies?

A: I frequently deliver lectures on breast cancer detection and have prepared a set of slides that I will soon present on breast cancer screening and risk reduction to our family medicine department.

Q: What key message would you like to communicate to community doctors and primary care physicians to promote timely screenings and ensure that patients receive accurate early detection information?

A: I truly want to highlight and advocate that regardless, the recommended age to start a screening mammogram is age 40, not age 50. And it is annual, not every two years. I want to make sure that the message is being amplified, as many of my cancer patients are quite young. Interestingly, we have observed that from 2016 to 2023, the incidence of breast cancer for women younger than 50 has increased by 2% each year. Hence, in May 2024, the US Preventive Service Task Force amended their recommendations. They now recommend screening mammograms from age 40 and every year.

Q: Can you discuss your recommendations for the HPV vaccine and cervical cancer screenings?

A: I strongly advocate for the HPV vaccine as a key preventive measure against cervical cancer as studies show it can prevent over 90% of cases. If we have a vaccine to prevent cancer from occurring, then we should all go for that. I recommend that both girls and boys receive the vaccine early. Also, I like to emphasize the importance of regular cervical cancer screenings to catch any issues early, which significantly reduces the risk of advanced disease.

Q: Could you explain your recommendations for cancer screenings and how you adjust them based on individual risk factors and family history?

A: In my practice, while I primarily focus on women’s cancer, I ensure that all patients stay current with their cancer screenings. I recommend that women begin annual mammograms at age 40 and keep up with regular Pap smears. Additionally, colonoscopies are now advised to start at age 45. For patients with a family history of cancers, such as breast, ovarian, or colon cancer, I suggest beginning screenings about 10 years earlier than the age at which a relative was diagnosed. For past smokers, I also recommend a low-dose chest computed tomography (CT) for lung cancer screening. I review these personalized screening guidelines with each patient at every visit to promote early detection and improve outcomes.

Q: Given that you have been a chair and speaker at several Binaytara conferences, what is your perspective on how Continuing Medical Education (CME) conferences can help educate doctors on the latest advances in cancer prevention and early detection?

A: CME conferences are invaluable for keeping physicians informed amid the overwhelming volume of new research. The Binaytara meetings I have chaired and spoken at provided a platform to analyze emerging studies, determine which findings are ready for clinical practice, and foster interdisciplinary collaboration. Experts from various specialties—oncology, gynecology, internal medicine, radiology, and more—offer diverse perspectives, leading to productive discussions and consensus-building. I received a lot of positive feedback on the debates and Q&A because that was a very clear example that even if it is the same study, we can have very different perspectives. Overall, these CME sessions further enhance learning, ensuring that physicians stay updated and ultimately improve patient care.

Q: How important is community education in cancer prevention, and what role should physicians play in raising awareness?

A: Community education is just as crucial as educating physicians. While doctors play a key role in treating patients, they must also step outside the clinic to engage directly with the community. I do community outreach whenever possible, but time is often limited. This is why the work of foundations and organizations, like Binaytara hosting educational events is so valuable. Raising awareness ensures that patients and communities are informed about prevention and early detection, ultimately leading to better health outcomes.

Do you have any burning questions about cancer care or anything related that you would like our experts to address? Feel free to send them here, and we will make sure they are covered in our upcoming discussions!