Half of all men in the U.S. will develop cancer during their lifetimes, with prostate and colorectal cancers being the most prevalent and greatest cause of death. Screening tests can be done for some types of cancers so they can be found as early as possible, while they are small and before they have spread. In general, the earlier a cancer is found and treated, the better the chances are for living many years. However, while routine screening is recommended for colorectal cancer, routine prostate cancer screening is controversial.
Screening for colorectal cancer reduces the risk of dying from this disease. Regular screening is initiated at age 50 for patients with an average risk for this cancer and earlier for those with increased risk, including those with risk factors, family history or known genetic syndrome. Several screening strategies are available and guidelines differ somewhat in recommended testing. Screening colonoscopy is most commonly used, but other options include screening with fecal occult blood test (FOBT), flexible sigmoidoscopy or combination of the two. The recommended interval between screenings depends on the method used, findings and risk factors present for individual patients. Screening for prostate cancer remains controversial and generally discouraged.The benefit of reducing the risk of dying from the cancer is small and potentially outweighed by the significant harms that affect men as a result of the screening and treatment methods.This includes the need for a biopsy to be done and impotence or incontinence occurring in at least 50 percent of men who undergo treatment for a disease that may have never shown up during their lifetime. However, screening is considered for men at higher risk; those with known risk factors, African Americans or a positive family history and between the ages 50-69. Screening is performed with blood test for prostate specific antigen (PSA) levels. When a decision is made to conduct the screening, the optimal interval for PSA testing is uncertain. Usual recommended intervals are every two to four years, stopping no later than age 75.
The good news is the risk of developing many types of cancer can be reduced by changes in lifestyle; for example, by staying away from tobacco, limiting time in the sun, being physically active and eating healthy. Such changes also protect against chronic diseases like cardiovascular disease, stroke and diabetes. Men who would like to know if they should be screened for cancer should make an appointment with their primary care physician.
Dr.Varma is a hematologist and medical oncologist and is affiliated with Raritan Bay Medical Center (RBMC) and its Center for Women, providing comprehensive and state-of-theart diagnostic testing. She has office locations in Edison, Old Bridge and Marlboro. For an appointment, call 732-452-9700 or RBMC’s free physician referral service 1-800-DOCTORS.