Wednesday, November 22, 2023

Cancer-Screening Tests Men Should Get

 Medically Reviewed by Sabrina Felson, MD on May 07, 2022, Written by Stephanie Watson

Going to the doctor for an annual checkup may not be the most exciting thing you can think of, but don't wait to get a screening test for the most common cancers that affect men. They're easier to treat when you catch them early.

Colorectal Cancer

Since the disease usually starts with growths called polyps in your colon, some screening exams look for them. The goal is to find them -- and remove them during the exam -- before they turn into cancer or while they're still precancerous.

Colonoscopy. Your doctor puts a flexible tube with a tiny camera into your rear end so they can see the inside of your colon and rectum. A day or so before the test, you can't have food -- only clear liquids -- and you'll need to drink a laxative.

The procedure takes about 30 minutes. You'll get medicine to make you drowsy or put you to sleep, as well as numbing medication. Your doctor will usually remove any polyps and perhaps bits of tissue from your colon. Then they’ll send them to a lab to get checked for signs of cancer.

Flexible sigmoidoscopy. It's like a colonoscopy, but it only lets your doctor see about a third of your colon. You don't have to do as much prep, and you can usually stay awake. This test takes about 20 minutes.

Fecal tests.  Both the guaiac-based fecal occult blood test (gFOBT) and the fecal immunochemical test (FIT) look for tiny amounts of blood in your poop, because cancers in the colon and rectum sometimes bleed.

You'll collect a small amount of your poop with a special kit at home, and then send it to a lab. You might have to avoid certain foods and medicines beforehand.

A stool DNA test is similar, but the lab will also check for traces of cells from polyps or cancer with changes in their genes.

Men should start getting screened at 50 years old, but you might need to start earlier if you're at high risk for colorectal cancer. If you're older, ask your doctor whether you still need to.

The U.S. Preventive Services Task Force (USPSTF) -- a panel of medical experts -- recommends you have a:

Colonoscopy once every 10 years, or

Flexible sigmoidoscopy every 10 years, plus FIT every year (but the (American College of Physicians says flexible sigmoidoscopy every 5 years, plus FOBT or FIT every 3 years), or

FOBT every year

Prostate Cancer

It's the second most common cancer in men. Different health groups have their own guidelines. Your doctor can recommend which tests you should have and how often to get them.

PSA (prostate-specific antigen). It looks for a protein in your blood that prostate cells release. Cancer causes the PSA level to rise. The problem is that other conditions, like an enlarged prostate, can also raise those levels.

Digital rectal exam (DRE). During this test, you either bend forward while standing or lie on your side on an exam table. Then your doctor puts a lubricated, gloved finger into your rectum to feel for any lumps in your prostate. You might bleed a little bit afterward.

The USPSTF doesn't recommend the PSA test, and some experts don't recommend the DRE for screening. The American Cancer Society suggests you talk to your doctor about what makes sense for you.

Most men may want to get a PSA test, and possibly a DRE, starting at age 50. If you're Black, have or may have a faulty BRCA1 or BRCA2 gene, or other men (especially younger than 65) in your family have had prostate cancer, you may need to start testing earlier.

Lung Cancer

It's the deadliest cancer in men. Smoking is a big reason, so you should get a screening test if you've got a long history of tobacco use.

Doctors check for lung cancer with an LDCT (low-dose computed tomography) scan. This test uses X-rays to take pictures of your lungs.

It's pretty straightforward. You lie on your back and raise your arms over your head as the table moves through the scanner. You'll have to hold your breath for 5 to 10 seconds while it's done.

You should probably get an LDCT scan once a year if you:

Are 50 to 80 years old

Have smoked at least a pack a day for 20 years (or an equal amount, such as two packs a day for 10 years), and

Smoke now or you quit within the past 15 years.

Your doctor will let you know if and when it's OK to stop getting annual scans.

Skin Cancer

The USPSTF doesn't make a recommendation one way or the other about skin exams. But the American Cancer Society says regular checks by your doctor are a good way to find skin cancers early when they're easiest to treat. If you've had the disease in the past, or you have family members who've had it, ask your doctor how often you should get a skin exam.

Your doctor will look for any moles or other growths on your skin that might be cancer. You can also check your skin yourself at least once a month for changes.

Cancer Screenings

Medically Reviewed by Sabrina Felson, MD on November 07, 2022 Written by Paul Frysh

Your doctor may suggest a cancer screening to check for signs of early cancer -- or to look for things that could turn into it. A screening is a test that helps find a disease before you have any symptoms - or your cancer has spread, making it harder to treat.

This screening process is helpful for several cancers, including:

Breast

Cervical

Colon

Lung (for some people)

You may be able to improve your outcome if you catch early signs and start treatment.

Still, there are pluses and minuses to different screenings. Your age, sex, genes, and overall health all make a difference.

It's not yet clear if screening for other cancers, such as ovaries, pancreas, prostate, and thyroid, helps improve outcomes.

Talk to your doctor about the best screening plan for you.

Breast Cancer Screening

The standard screening test for breast cancer is called a mammogram. It uses X-rays to take a picture of the inside of your breast.

If you have greater chances of getting breast cancer because of your genes or other issues, you may also need to get an MRI, which uses radio waves to take pictures.

Different health organizations have their own guidelines about when women should get breast cancer screening. The CDC, for instance, says from ages 50 to 74, women at average risk should get a mammogram every 2 years, but from ages 40 to 49, women should talk to their doctor about the pros and cons of breast cancer screening.

 The American Cancer Society, on the other hand, says all women should begin having yearly mammograms by age 45 and can change to having mammograms every other year beginning at age 55. It says women should have the choice to start screening with yearly mammograms as early as age 40 if they want to.

Because there are differing recommendations, work with your doctor to figure out the best option for you.

No matter what your age, it's a good idea to get familiar with the way your breasts look and feel and to report any changes to your doctor.

Cervical Cancer Screening

This is cancer of the cervix, the small tunnel of tissue that connects a woman's vagina to her uterus (womb).

There are two main screening tests for cervical cancer:

Pap test (Pap smear). It looks for cancer cells or cell changes that might turn into cancer without the right treatment.

HPV test. It checks for certain types of the virus known as HPV, which might cause cell changes that turn into cancer.

Your doctor will scrape some cells and mucus from your cervix to use for the two tests.

Some general rules about screening for cervical cancer:

It starts at age 21.

From age 21 to 29, you'll get a Pap test. If it's normal, it may be OK to wait 3 years before your next one. Ask your doctor.

From age 30 to 65, your doctor can decide whether you need a Pap test, HPV test, or both. Normal results could mean you wait up to 5 years for the next one.

After 65, your doctor might suggest no more screening if your tests have been normal for a few years or you've had a hysterectomy -- surgery to remove the uterus and cervix.

Colon Cancer Screening

There are several screening tests for colon cancer:

Colonoscopy. Your doctor puts a flexible, lighted tube through your anus and into your rectum. A camera allows them to look for small growths (polyps) as well as for signs of cancer in your colon -- a part of the digestive system that's also called the large intestine. Your doctor can usually remove any suspicious growths to look at under the microscope.

Sigmoidoscopy. This works the same way as a colonoscopy but doesn't go as deep into your colon.

Stool tests. These look for blood in your bowel movement, and sometimes for cell material (DNA) that has changed in a way that could be a sign of cancer. You may be able to collect the sample at home and return it to your doctor or testing lab.

Virtual colonoscopy. Your doctor might call it a CT colonography. A CT scan takes multiple X-rays, and computer software turns them into a picture of the inside of your colon. A doctor called a radiologist will talk to your medical team about what they mean.

If you get an abnormal result from a sigmoidoscopy, stool test, or virtual colonoscopy, your doctor will likely recommend that you get a colonoscopy.

Screening for colon cancer starts at age 45 for men and women. You may need to start screening at an earlier age if you have a family history of colon cancer or certain conditions that raise your odds of getting the disease. After 75, you and your doctor can decide whether you need to get a screening for colon cancer.

If you get a colonoscopy and you're not at high risk for colon cancer, your doctor may suggest you wait up to 10 years before your next one.

Lung Cancer Screening

Most people don't need screening for lung cancer. If your doctor suggests you get it, the only test is a low-dose CT scan that takes detailed pictures of your lungs. It takes just a few minutes and it doesn't hurt.

Lung cancer screening is only helpful if you have all of these:

History of heavy smoking (pack a day for many years)

Smoke now or quit in the last 15 years

Are between ages 50 and 80

SOURCES:

American Cancer Society: "Cancer Screening Guidelines By Age."

American Society of Clinical Oncology: "Cancer Screening," "Colorectal Cancer: Screening."

CDC: "Lung Cancer," "Cervical Cancer," "Colorectal (Colon) Cancer," "What Is Breast Cancer Screening?" "Screening Tests."

National Cancer Institute: "Screening Tests."

U.S. Preventive Services Task Force: "Published Recommendations."

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