Dear Doc,
I often read about women’s cancer screening issues in the media in the month of October but what about men? As a male, I know I have different health concerns from women. What cancers should I be screened for as a 52- year-old male?
Doc,
There is no doubt that men and women are different. Besides the obvious differences, woman use 7,000 more words per day (20,000 words versus 13,000 words), men’s brains are 11 percent bigger (no men, this has nothing to do with smarts but more to do with body size), and woman are three times more likely to go to the doctor. This may be why in 1900, men and woman in the U.S. had similar life expectancies but today, woman in the U.S. live on average to the age of 81, while men in the US are expected to live only to age 76. Of note, despite spending the most on health care in the world, the U.S. ranks 26th in life expectancy! People live longer in Slovenia, Denmark, and Switzerland (which ranked first).
Cancer is a significant health concern for both men and woman. Cancer is the second leading cause of death in the U.S. and the leading cause of death in those younger than 85. Women have a one in three chance of developing some form of cancer and a one in five chance of dying from cancer. Meanwhile, men have an even higher risk. Men have a one in two chance of developing cancer and a one in four chance of dying from cancer.
Four cancers account for nearly half of all cancer deaths: lung (27%), colorectal (9%), breast (14% in woman) and prostate (10% in men). The U.S. Preventive Services Task Force (USPTF) recommends screening for colorectal cancer in adults 50 to 75-years-old. Screening for colon cancer can be done by checking your stool for microscopic blood as cancers and precancerous polyps may leak a small amount of blood in your stool. Also, a screening colonoscopy, a scope of your entire colon done under sedation is recommended starting at age 50. It is estimated that more than 25 percent of those eligible for colon cancer screening have never been screened and another 7 percent are not up to date with recommended screening.
Prostate cancer can be screened for by a digital rectal exam where your doctor actually feels for nodules on your prostate. This exam should be performed yearly on men over the age of 40. The blood test, PSA (prostate specific antigen) has been used in the past to screen for prostate cancer. Over the years however, it has been discovered that many men die with prostate cancer instead of from prostate cancer. Wide scale screening with the PSA test has led to an increase in the diagnosis of prostate cancer and treatment of prostate cancer. Evidence suggests many of these discovered cancers do not need to be aggressively treated. The treatment for prostate cancer can lead to significant complications such as impotence and incontinence. So the USPTF recommends against routine PSA testing. However, if you are a male between 55 and 69, the American Urological Association recommends shared decision making between you and your doctor about getting a PSA test. If you have a risk factors for prostate cancer (family history, obesity, African American decent), your doctor may advise you to get a PSA test.
Lung cancer accounts for 27 percent of all cancer deaths in the U.S. and it will be diagnosed in 7 percent of Americans. Ninety percent of lung cancers are due to smoking. In the past, chest x-rays were used to screen smokers for lung cancer, but studies have shown that screening chest x-rays showed no reduction in lung cancer deaths. More recent evidence suggests that a low radiation CAT scan (a test that shows much more detail) of the lungs may detect lung cancers early. The USPTF recommends annual low dose CAT scan screening for significant smokers between 55 and 80-years-of-age and for significant smokers who quit within the previous 15 years.
So, 52-year-old male, I could have said it in fewer words (word economy) and just answered your question by saying if you smoke, get a low radiation CAT scan, get your prostate checked, discuss a PSA test with your doctor, and get a colonoscopy for your cancer screening; but, I have many female readers and wanted them to enjoy the many words of this column as well!
Stay healthy and remember the quote by Albert Einstein, “Men marry women with the hope they will never change. Women marry men with the hope they will change. Invariably they are both disappointed.”
Dr. Nagpaul is a medical doctor and is board-certified in Internal Medicine. He currently is the Medical Director at Newark-Wayne Community Hospital, DeMay Living Center and Wayne County Public Health. This column is meant to be educational and not intended to be used to make individual treatment decisions. Prior to starting or stopping any treatment, please confer with your own health care provider. To send questions, please email Dr. Nagpaul at Arun.Nagpaul@rochesterregional.org and put “Ask a Doc” in the subject line.
