This article is more than 5 years old. Information may no longer be current.
What cancer screenings are recommended for men?
Men have a 42% chance of developing invasive cancer during their lifetime, and a nearly 23% chance of dying of cancer, according to American Cancer Society statistics.
Early detection dramatically increases the potential for treatment success, illustrating the importance of routine screenings that can detect cancer prior to symptom onset.
Screening recommendations for men vary based on age, family health history and other characteristics. Consequently, men should speak with their health care providers to determine which screening tests are most appropriate for them.
However, to help with the discussion, HemOnc Today compiled this guide to common cancer screening tests for men.
Colorectal cancer
Excluding skin cancers, colorectal cancer is the third most common malignancy diagnosed in the United States, according to the American Cancer Society.
An estimated 134,490 cases of colon or rectal cancers will be diagnosed nationwide in 2016, and 49,190 Americans will die of the disease this year, according to society statistics.
A man’s lifetime risk for developing colorectal cancer is 1 in 21, or approximately 4.7%.
Routine colorectal cancer screening should be performed among adults aged 50 to 75 years, according to an updated recommendation released by the U.S. Preventive Services Task Force. The decision to screen adults aged 76 to 85 years should be based on a person’s overall health and prior screening history, the task force concluded.
The task force also found convincing evidence that several screening methods can accurately detect early-stage disease and adenomatous polyps. Most guidelines recommend colonoscopy be performed once every 10 years, sigmoidoscopy every 5 years and fecal occult blood test annually.
Despite growing evidence of the effectiveness of colorectal cancer screening, it “is a substantially underused preventive health strategy in the United States,” task force chair Kirsten Bibbins-Domingo, PhD, MD, MAS, and colleagues wrote in their recommendation statement.
Prostate cancer
Prostate cancer screening typically is performed through a PSA test, with or without a digital rectal exam.
The U.S. Preventive Services Task Force recommends against PSA screening for prostate cancer for all healthy men, regardless of age.
Members of the task force concluded that the harms of PSA testing outweigh the benefits. Still, they said the ability to offer screening rests in the hands of health care providers. They urged clinicians and health care providers to individualize decision-making based on a patient’s circumstances.
Critics suggested the task force overestimated the harms of prostate cancer screening, underestimated its benefits and based its recommendations largely on flawed studies with inadequate follow-up.
Experts typically recommend men speak with their health care provider about prostate cancer testing beginning at age 50 years. The conversation should start at age 45 years if the patient is black or if one of the patient’s immediate family members has been diagnosed with prostate cancer prior to age 65 years.
Study results published in June suggested a single baseline PSA level measured during midlife can predict development of lethal prostate cancer.
Lung cancer
The U.S. Preventive Services Task Force recommends adults aged 55 to 80 years with a 30 pack-year smoking history who either still smoke or quit within the prior 15 years undergo annual screening with low-dose CT.
More than 8 million American adults meet these eligibility criteria.
Other entities — including the American Cancer Society, National Comprehensive Cancer Network and American Lung Association — recommend some form of lung cancer screening with low-dose CT.
The USPSTF guidelines are based in part on the results of the National Lung Screening Trial, which included 53,454 adults aged 55 to 74 years who were at high risk for lung cancer. Researchers randomly assigned participants to annual low-dose CT or single-view posteroanterior chest radiography for 3 years.
The results, published in 2011 in The New England Journal of Medicine, revealed a 20% (95% CI, 6.8-26.7) reduction in lung cancer mortality with low-dose CT.
Some clinicians have cautioned that the benefits of annual screening must be balanced with risks, which include the potential for overdiagnosis, a high frequency of false-positive results and increased radiation exposure.
Others suggest the decline in smoking rates will translate to fewer people qualifying for lung cancer screening, thereby potentially leading to higher rates of lung cancer mortality.
Melanoma/s kin cancer
Routine screening for skin cancer is not recommended due to a lack of data that suggest a benefit.
However, men are encouraged to perform regular self-exams to check for new or changing lesions that may be cancerous or precancerous.
Standard criteria include asymmetrical shape, irregular borders, presence of more than one color or even distribution of color, diameter of 6 mm or larger, or evolution of a mole.
Men at the greatest risk for melanoma include those with fair skin, those aged 65 years and older, those with atypical moles and those with more than 50 moles on their body.
Physicians who perform physical examinations on patients for other reasons should look for skin abnormalities.
Other self-examinations
Men also are encouraged to perform monthly self-examinations for testicular cancer. The exams are best performed after a warm shower or bath when the scrotum is relaxed, according to the Testicular Cancer Society.
Men should check for swelling of the scrotal skin, as well as irregularities on the surface or texture of the testicles. Men who detect bumps, lumps or irregularities should seek medical attention.
Experts also emphasize that men can develop breast cancer. Periodic self-exams can detect lumps, knots or thickening in the breast, as well as changes in the shape or size of the breast. Other irregularities may include redness of the skin, as well as itchy sores or rashes on the nipple.
Risk factors include obesity, older age and prior radiation to the chest.
Studies suggest higher age-adjusted incidence among black men and white men than Hispanics or Asian/Pacific Islanders. Blacks also appeared more likely to be diagnosed at a younger age and a more advanced disease stage than whites or Asians/Pacific Islanders.
Men at high risk for breast cancer due to mutations in the BRCA1 or BRCA2 genes, as well as those with a strong family history of breast cancer, are urged to undergo a clinical breast exam every 6 to 12 months starting at age 35 years. They also should consider undergoing a mammogram at age 40 years.
Additional information can be found at the following websites:
blogs.cdc.gov/cancer/files/2016/06/cheat-sheet-mens-cancer-screenings.pdf
http://www.cancer.org/cancer/news/features/4-cancer-screening-tests-for-men
http://www.cancer.org/cancer/colonandrectumcancer/detailedguide/colorectal-cancer-key-statistics