Cancer Screenings
No one wants to hear it – the C word. Cancer. But according to statistics from the American Cancer Society and the National Cancer Institute, about 40% of Americans will be diagnosed with some form of cancer in their lifetimes.
Cancer sometimes strikes at random. But it’s important to be aware of a number of risk factors that can make the diagnosis more likely for some people. These risk factors vary by cancer type, but the big ones are age, genetics or family history, and your individual health status.
Most cancers aren’t entirely preventable, but patients can take a number of steps to lower their risk, especially with regard to cancers with strong environmental components, like lung or skin cancer. If you quit smoking and wear sunscreen, you can lower your risk for those types of cancer.
Still, cancer sometimes comes anyway, and that’s what makes early detection so important. The sooner we catch cancer, the more options we have for treating it successfully.
The “Big Three” Cancer Risks
Although different cancers have different risk factors, three of those factors tend to show up more than others – age, genetics, and overall health status.
Age
Age is by far the most widespread risk factor. The vast majority of cancers, nearly 90% of new diagnoses, are among adults older than 50. This is one reason regular wellness checkups are so important.
Genetics/Family History
Some cancers do seem to strike randomly. But many, especially breast, ovarian, prostate, and some skin cancers, have strong genetic components.
If your parents or grandparents had one of these cancers, it can raise your risk. Make sure your primary care provider knows about any family history of cancer so they can monitor you appropriately.
The good thing here is that we have learned a lot about the specific genetic risk factors at play with these types of cancer. In some cases, we can even look for specific gene mutations.
Overall Health
A number of chronic conditions and diseases can raise your risk for certain cancers. Obesity, HPV and Hepatitis are well-known for raising cancer risks. And that risk extends to a variety of cancers.
Make sure you’re managing these and any other conditions appropriately with your primary care provider(s) to reduce your risks.
Questions to Ask Your Doctor
Cancer screenings should become part of a regular wellness checkup by age 50, at the latest. For some cancers, especially if you have a family history, screenings may need to start earlier. Regardless of your age and family history, it’s a good idea to discuss these with your doctor so you know what to expect. Here are a few questions you may want to ask at your next appointment.
What screenings am I due for based on my age?
Does my family history impact my screening timeline?
What screening options do you recommend for my schedule and comfort level?
What symptoms should I watch for?
Now, let’s go over a few of the most common types of cancer.
Colorectal Cancer
Colon cancer often starts as a polyp. Screenings can identify polyps before they become cancer, or they may catch cancer when treatment is more successful. Early detection can make this particular cancer very treatable or preventable in some cases.
You’ve probably seen headlines about colorectal cancer lately. Successful treatment is common among older adults due to regular screenings and early detection. Unfortunately, it’s hitting younger adults harder because it’s not as often caught early.
For that reason, this is one of those cancers we begin screening for at younger ages. For patients with no concerning risk factors, we’ll begin by about age 45.
Colorectal Cancer Risk Factors
Your risk for colorectal cancer may be increased if you have:
A parent/sibling/child with colorectal cancer or advanced polyps
An inflammatory bowel disease like Crohn’s or ulcerative colitis
A known hereditary syndrome such as Lynch or FAP
Screening Options for Colorectal Cancer
There are two primary screening options for colorectal cancer.
A colonoscopy can find and remove polyps.
Stool tests can be done at home, but positive tests may need a follow-up colonoscopy.
The “best” test is one you will complete on schedule.
Breast Cancer
Breast cancer screening is meant to catch cancer before it can be felt as a lump or other abnormality. Recommendations may change for patients with a family history or other risk factor(s). Bottom line: mammograms save lives by detecting this cancer early.
The guidelines for breast cancer screenings are by both age and risk factors:
Age 40-74 – Get a mammogram at least every two years if your doctor defines your risk as average.
Age 75+ – Discuss screenings with your doctor based on your health and life expectancy.
Any age – If you’re considered high-risk, you may benefit from earlier screenings, genetic testing and/or a breast MRI.
Breast Cancer Risk Factors
Your risk for breast cancer may be increased if you:
Test positive for the BRCA gene or have another known hereditary cancer mutation
Have a strong family history of breast and/or ovarian cancer
Had chest radiation at a young age
Screening Options for Breast Cancer
The most common breast cancer screening is a mammogram.
Additional screening options do exist when necessary. For example, dense breast tissue may make mammograms difficult to read. In those cases, patients may benefit from 3D mammograms, ultrasounds or a breast MRI.
Additionally, patients with a significant family history of breast cancer may benefit from genetic counseling.
Overall, breast awareness is important. Patients should report any new lumps, discharge, dimpling or persistent breast pain to their doctors.
Prostate Cancer
Prostate cancer is often treatable, and screening can lead to early detection and improve treatment outcomes for many men. Prostate cancer is also unique in that some screenings can lead to false alarms.
The guidelines for prostate cancer screenings are by both age and risk factors:
Age 55-79 – Discuss screenings with your doctor based on your age and individual health status.
Age 70+ – Many men no longer get routine screenings at this age.
Any age – Some high-risk groups may benefit from earlier screening, especially those with a strong family history and/or Black adults.
You may have done a double-take on the “many men over 70 no longer get routine prostate cancer screenings.” It’s not a typo, and it doesn’t mean you cannot or should not get one. It’s a general recommendation.
In recent years, we’ve learned a lot about prostate cancer, and we’ve seen some over-diagnosis in older men. Tumors may be present, but they may also be slow-growing and not very responsive to available treatments. The available treatments, in addition to being less effective in these patients, often result in significant negative side effects. Past age 70, screenings should always be discussed with your doctor in the context of the risks, side effects, and other health considerations – which play an outsize role in this age group.
Prostate Cancer Risk Factors
Your risk for prostate cancer may be increased if you:
Have Black ancestry
Have a father, brother or son with prostate cancer
Have a known BRCA2 or other hereditary cancer risk
Key Points About Prostate Cancer
Let’s be clear – prostate cancer isn’t “nothing to worry about.” But we don’t screen blindly. The approach is personal. Always discuss concerning symptoms with your doctor, especially those like bloody urine or bone pain. And don't worry about the screening itself – physical exams aren't usually the norm anymore. Many early screenings are just a blood test!
Other Cancers
Not every cancer has a routine screening or test. Some screenings depend heavily on age, smoking history, anatomy, prior results, family history, environmental factors, or symptoms.
Here are a few guidelines for other cancer screenings by age:
Age 21-65 – Cervical cancer, with intervals determined by the results of pap smears and/or HPV tests
Age 70+ – Lung cancer, especially for patients with a history of smoking or exposure to secondhand smoke
Any age – Skin checks, genetic screenings, and symptom-driven evaluation are decisions best made in partnership with your provider(s).
When should I ask about a cancer screening?
Certain symptoms or health indicators should always lead to a conversation with your doctor(s). These include:
Regular pap smears if you have a cervix
HPV screenings, as indicated
A history of smoking, especially if you still smoke or have quit within the last 15 years
Unusual moles (especially those that fit the ABCDE criteria for potential skin cancer)
A sore that won’t heal
Unexplained bleeding
Sudden or unexplained weight loss
Persistent pain, especially bone pain
Non-Routine Cancer Screenings
When we say “non-routine,” we mean that these typically aren’t for any patient any time. A number of risk factors play in, including your own health status and your family history.
Screenings are available, when indicated, for cancers like pancreatic, testicular, ovarian, and thyroid.
Whole-body scans may be ordered for patients who need them.
Tumor-marker blood panels are usually for patients with a specific indication.
Generally, we try to avoid testing because of anxiety, rather than risk. The most important thing you can do is maintain your annual wellness visits, live a healthy lifestyle, and know your family history.
Ready to see a provider?
The board-certified providers at The Kinder Clinic are available to assess your needs and support your health. Click here to request an appointment, or call us at 337-738-2713.
Comments