Cancer Screening program for men

Overview

Cancer is the second greatest cause of mortality in the United States, after only heart disease. Cancer screening is a method of cancer prevention and early detection. According to the Centers for Disease Control and Prevention, new cancer cases are predicted to exceed 1.8 million in 2020, with 606,520 cancer fatalities. Fortunately, some cancers, such as colon, lung, cervical, and breast cancer, may be diagnosed by screening, which aids in delaying or even arresting disease growth.

Cancer screening is a type of secondary prevention in which cancer mortality is lowered but the incidence remains same. Due to the large lag time in the malignant transformation, screening allows for the detection of premalignant lesions, early intervention in the carcinogenic process, and postponement of cancer progression. The majority of cancer risk factors are avoidable.

Eliminating tobacco use and secondhand smoke exposure, getting vaccinated (HPV-Human Papilloma Virus), avoiding tanning beds, maintaining a healthy weight, staying physically active, avoiding processed or red meat, and eating a healthy diet rich in fruits and vegetables are just a few of the measures that can significantly reduce a person's lifetime risk of developing or dying from cancer.

What is Cancer screening tests?

Cancer screening tests are intended to detect cancer or pre-cancerous regions before symptoms appear. In general, this is when therapies are most effective. Several organizations have established guidelines for men's cancer screening. While these guidelines range significantly from one another, they all include the same basic screening tests, including those for prostate and colorectal cancers.

During routine health checks (at any age), your healthcare practitioner may screen for skin, oral, thyroid, and testicular malignancies. Not every screening test is appropriate for everyone. Your personal and family cancer history, as well as the presence of a known genetic susceptibility, might influence which tests are appropriate for you and when you start them. Make an appointment with your healthcare professional to go through these details.

Screening guidelines for men

The following cancer screening recommendations are for males who are at average risk for cancer (unless otherwise noted) who do not have any particular symptoms. Men who are at a higher risk for specific cancers may require a modified screening plan, such as starting at a younger age or getting checked more frequently. Those who are experiencing symptoms that may be connected to cancer should consult their doctor as soon as possible.

Each kind of cancer has its unique set of age-related risk factors. Follow this cancer screening for men guide by age and cancer type, or use the buttons below to get to a specific part.

Lung Cancer

Lung cancer is one of the leading causes of death from cancer. In the year 2020, new cases and deaths due to lung cancer in the US are estimated at 228,820 and135,720, respectively.

One of the world's biggest multicenter randomized lung cancer screening trials was evaluating LDCT (Low Dose Lung Computed Tomography) in lung cancer screening. The primary outcome was lung cancer death. The study concluded that lung cancer screening with LDCT reduced mortality by 20%.

Adults aged 55 to 80 years who are presently smoking or have a 30-pack-year smoking history and have quit within the past 15 years are advised to get yearly low dose lung computed tomography, according to USPSTF guidelines . Screening is no longer required once a person has not smoked for 15 years, has a reduced life expectancy, or is unable to have curative lung surgery owing to health issues.

Except for the age range of 55 to 74 years, the ACS guideline is equivalent to the USPSTF proposal. If the patient is a current smoker, they should have received evidence-based smoking cessation counseling, and they should have gone through an informed/shared decision-making process that included information about the potential benefits, harms, and limitations of screening with LDCT, as well as access to a high-quality lung carcinoma screening and treatment center.

Previous research has demonstrated that if the screening is adopted in the target population as outlined in the NLST study, 12,250 lung cancer deaths can be avoided.

Colorectal Cancer

Colorectal cancer (CRC) is the second leading cause of mortality from cancer in the United States. According to NIH (National Institute of Health) figures, there will be 147,950 new instances of colorectal cancer this year, with 53,200 deaths from the disease.

CRC screening options include an annual high-sensitivity fecal immunochemical test, an annual guaiac-based fecal occult blood test, a multitarget stool DNA test every three years, a colonoscopy every ten years, a flexible sigmoidoscopy every five years, and computed tomography colonography every five years.

The American Cancer Society's colon cancer screening guidelines were modified in 2018. Colon cancer incidence and death have reduced during the last two decades, owing mostly to screening methods. Adults 45 years and older with an average risk of CRC are screened using either a high-sensitivity stool-based test or a structural (visual) examination, depending on patient desire and test availability. Positive screening test findings on non-colonoscopy should be followed up with a quick colonoscopy as part of the screening strategy.

The ACS highly advises persons aged 50 and up to begin screening using the above-mentioned technique. Adults with an average risk and excellent health who have a life expectancy of more than 10 years can continue to be screened for CRC until the age of 75. CRC screening decisions in individuals aged 76 to 85 years should be customized based on patient preferences, health state, life expectancy, and past screening history. People above the age of 85 should be discouraged from continuing CRC screening.

A high-risk patient is someone who has a CRC family history or a documented advanced adenoma at the age of 60 in a first-degree relative, or two first-degree relatives with the above findings at any age, and they should have a colonoscopy every five years starting ten years before the youngest affected relative's diagnosis or at the age of 40, whichever comes first. Persons with a single first-degree relative diagnosed with CRC or an advanced adenoma at the age of 60 can be evaluated for average-risk screening choices at the age of 40.

Colonoscopy is the gold standard screening method for colorectal cancer. It allows us to diagnose and resect precancerous and cancerous lesions, with statistics revealing that the risk of colonic perforation in screening/surveillance colonoscopy was 0.010 percent and 0.022 percent in diagnostic colonoscopy.

Stool Based Tests

The guaiac fecal occult blood test (gFOBT) detects blood in feces using heme peroxidase activity. It is non-invasive, cheap, and utilized as a screening technique that is supported by high-quality data from randomized controlled studies. The technique is based on simple oxidation. As a result, any dietary peroxidase, such as peroxidase in plants, heme from myoglobin in red meat, or antioxidant, such as vitamin C, might skew the results.

Because FIT- is an antibody to human globin, a cross-reaction to eating meat is improbable. As upper GI (gastrointestinal) globin is destroyed by digestive proteolytic enzymes, it detects colonic blood. According to a recent comprehensive review and meta-analysis, the overall accuracy of FIT for detecting CRC is 95%, with a sensitivity of 79% and a specificity of 94%.

Stool DNA test- In August 2014, the FDA (Food and Drug Administration) authorized Cologuard® as the first multitarget stool DNA test for CRC screening. It identifies aberrant DNA in stool samples from cancer patients. In a research that compared FIT to the stool DNA test, the latter exhibited better sensitivity but poorer specificity and a larger percentage of false-positives.

Screening using a stool-based test (gFOBT, FIT, and FIT-DNA) or direct visualization test is indicated at the age of 50. (colonoscopy every 10 years, sigmoidoscopy every 5 years, if done with the annual FIT then every 10 years and CT colonography every 5 years).

The FDA (Food and Drug Administration) recently authorized a serology test (SEPT 9 DNA) for CRC screening. During a comprehensive evidence assessment, however, there was a low sensitivity to identify CRC of less than 50%. This test has not been included in the list of colon cancer screening tests.

For individuals over the age of 75, the suggestion is consistent with the ACS standard, with a strong recommendation against colonoscopy after the age of 85.

Prostate Cancer

Prostate cancer is the second most common disease in males globally (after lung cancer), accounting for 1,276,106 cases and 358,989 deaths in 2018. It is worth noting that the incidence and death rate in African Americans is greater than in white males. Incidence and fatality rates similarly rose with age, with the average age at diagnosis being 66 years.

The current American Cancer Society (ACS) guideline, published in 2010, states that men with a 10-year life expectancy should be given the opportunity to consider screening for prostate cancer with serum prostate-specific antigen (PSA), with or without DRE, after making an informed/shared decision with their health care provider, provided they are informed about the uncertainties, benefits, and risks associated with prostate cancer screening and therapy.

Men at higher risk, such as those with a family history of prostate cancer (father or brother diagnosed before the age of 65) and African American men, should begin receiving information about prostate cancer screening at the age of 45. Men with a much increased risk (prostate cancer diagnosed before the age of 65 in numerous family members) should begin receiving screening information at the age of 40.

For males who are unable to make a decision, the decision to screen should be left to the discretion of the healthcare professional, who should take into account the patient's overall health preferences. Asymptomatic males with a life expectancy of fewer than ten years based on age and health condition should not be provided prostate cancer screening.

For men who choose to be screened for prostate cancer after an informed decision making:

The recommendation is to screen using the PSA test along with or without the DRE (DRE is recommended in men with hypogonadism along with PSA due to PSA's reduced sensitivity)
The interval between screening can be extended to every two years for men whose PSA is less than 2.5 ng/mL, and yearly screening for men whose PSA is 2.5 ng/mL or higher; and
If the PSA result is 4.0 ng/ml or greater in men at average risk for prostate cancer, a referral for additional assessment or biopsy is indicated. If the results are between 2.5 and 4.0 ng/mL, the individual's risk factors for developing high-grade prostate cancer should be reviewed, and the health care practitioner should decide whether to refer the individual for additional diagnostic examination. African American ethnicity, increasing age, a family history of prostate cancer, a high age-specific PSA level, and abnormal DRE are all risk factors for prostate cancer.

There is a tiny net advantage to screening for prostate cancer using a PSA-based test in men aged 55 to 69 years, and "the choice to undergo periodic PSA-based screening should be customized following discussion with their doctor of the possible benefits and hazards of PSA testing." The USPSTF continues to advise against PSA-based prostate cancer screening in men aged 70 and older, primarily because false-positive PSA readings cause more damage, including over-diagnosis, biopsies, and treatment in older men.

Sun Exposure and Skin Cancer Risk

Skin cancer is the most frequent kind of cancer, and its prevalence is increasing. However, it is one cancer that, in the majority of instances, may be avoided or discovered early. While it is true that you need the sun to produce vitamin D, you just need a few minutes every day to do so. Skin cancer can be caused by exposure to ultraviolet (UV) radiation, which can occur from natural sunshine or tanning beds.

UV radiation also cause wrinkles, loss of skin suppleness, dark patches (also known as age spots or liver spots), and pre-cancerous skin alterations (such as dry, scaly, rough patches). Although dark-skinned persons are less prone to acquire skin cancer, it can and does occur, most commonly in places that are not exposed to sunlight (on the soles of the feet, under nails, and genitals).

There are several things you can take to protect yourself from harmful UV radiation and to diagnose skin cancer early. Begin by applying a broad-spectrum sunscreen (which protects against UVA and UVB rays) every day, avoiding peak sun periods (10 a.m. to 4 p.m.), and wearing protective clothing such as hats, sunglasses, and long-sleeved shirts.

Examine your skin on a daily basis to become acquainted with any moles or birthmarks. If a mole has altered in any manner, you should have it examined by a healthcare expert. This includes a change in size, shape, or color, the appearance of scaliness, bleeding, oozing, itching, or discomfort, or the formation of a persistent sore. If you have a lot of moles, it may be useful to keep track of them using pictures or a mole map.

Head and neck cancer screenings

Males are twice as likely as females to acquire head and neck cancer. The majority of cases of the condition occur in the mouth, salivary glands, nose, or throat and are frequently caused by alcohol and cigarette use. Human papillomavirus (HPV) can, however, cause some forms of head and neck cancer. Experts urge that a patient's head, neck, and throat be examined as part of an annual physical, as well as his or her mouth at a semiannual dental checkup.

Most insurance plans include HPV vaccines, which are recommended for males and females aged 9 to 26. Adults aged 27 to 45 who have not previously been immunized are also eligible for the vaccination. Consult your doctor to see if the vaccination is good for you.

Cancer prevention

Aside from periodic health exams, there are additional measures to lower your chance of having cancer.

Obtain and keep a healthy body weight
Consult your health care provider about HPV vaccination.
Exercise on a regular basis. Understand your family history and behave accordingly.
Consume alcohol in moderation.
Use safe sex and avoid smoking and other kinds of tobacco.
Maintain a healthy diet high in fruits and vegetables and low in saturated fats.

Conclusion

Screening is the process of examining your body for cancer before you notice any signs. Regular screening tests may detect breast, cervical, and colorectal (colon) cancers early, when treatment is most likely to be effective. Screening for lung cancer is indicated for some persons who are at high risk.