New Screening Options Available for Lung, Colon Cancers
During Men’s Health Month in June, it’s a good time to remind men to consider screening for the three most common cancers that can impact them: prostate, lung and colorectal cancer.
National Cancer Institute statistics tell us that more than 1.7 million new cases of cancer will be diagnosed in the United States this year. The good news is the overall death rate from cancer in America has dropped by 25 percent since 1990. New screening options and early detection are key.
In terms of prostate cancer, one of the top discussions has centered around who should be screened and when. The American Cancer Society estimates there will be 165,000 new prostate cancer diagnoses this year in the U.S. with about 29,000 prostate cancer deaths.
About one in nine American males have a lifetime risk of developing prostate cancer, but the risk of dying of prostate cancer is only about 2.9 percent. Thirty percent of men at age 55 and 60 percent of men at the age of 80 will have prostate cancer. That speaks to the idea that many and perhaps most people with prostate cancer will actually die of something else.
Different groups have varying recommendations for screening, so we try to break it down into life expectancy. For instance, when people are felt to have a life expectancy of less than 10 years, the National Comprehensive Cancer Network (NCCN) and the American Cancer Society say screening for prostate cancer is probably not necessary. The American Cancer Society recommends prostate-specific antigen (PSA) testing for average-risk men starting at age 50, with annual testing for those who have high PSA levels and testing every other year for those in the normal range.
If prostate cancer is present, the NCCN recommends actions including active surveillance or treatment of the cancer, depending on progression of the disease and onset age.
While prostate cancer is the most common type of cancer among American men, lung cancer is the leading cause of cancer death in this group. Patients now have another option for screening and early detection of lung cancer. Previously, a chest x-ray was the standard for screening, but has not been shown to be consistently useful. Studies show that a low-dose CT scan, which became available at ThedaCare this year, detects cancer at a higher rate.
A three-year national lung screening trial, which included 53,000 patients ages 55 to 74 with a history of at least 30 pack years (a pack a day for 30 years, or two packs a day for 15 years), showed a 20 percent lower lung cancer mortality rate for groups who had been screened with a low-dose CT scan versus those who received standard chest x-rays.
Additionally, the study showed a 6.7 percent reduction in deaths of any cause among the low-dose CT group, meaning they were probably finding other things that needed attention.
Another benefit is the low-dose CT scan exposes people to only about a third of the radiation that they would receive during a standard CT scan, and is more sensitive than a chest x-ray in terms of finding small lesions that can be removed.
As with other types of cancer, screening and prevention or early detection of colon cancer is always desirable over needing to treat a more established colon cancer. We know that most colon cancers arise from polyps, and it can take 7 to 10 years for a polyp to become a cancer. Most recommendations agree that people should be screened starting at age 50, though some guidelines suggest African-Americans should be tested beginning at age 45.
Does colon cancer screening mean having a colonoscopy? Maybe. The typical recommendation is to have one every five to 10 years, depending on results and risk factors, such as having a first-degree relative with colon cancer or a history inflammatory bowel disease. But for those who prefer less-invasive screening, patients have the option of a CT colonography as well as other tests including fecal immunochemical testing (FIT) which can detect cancer cells.
Whatever method of screening you and your doctor choose, early detection is always important in successfully treating a cancer. Be sure to talk to your primary care provider about the best options for you and your care.
Anthony Phillips, MD, specializes in hematology and oncology at ThedaCare Cancer Care in Appleton and Waupaca.
