June is Men’s Health Month, which makes it a great time to review personal risk factors and follow up with crucial cancer screenings.
“It’s never too early to understand your risks for developing cancer,” said Endeavor Health’s Peter Hulick, MD, The Janardan D. Khandekar, MD, Chair of Personalized Medicine and Medical Director of Mark R. Neaman Center for Personalized Medicine.
Cancer screenings play a critical role in identifying potential health issues, even before symptoms appear. Unfortunately, many men skip routine screenings. Being proactive begins with understanding what screenings are available for men, and when to get them.
Prostate cancer
Prostate cancer is one of the most common cancers in men, and approximately one in eight males will be diagnosed with it. Medical experts have long recommended screening with a prostate-specific antigen (PSA) blood test but there is not uniform agreement on what age to begin screening. Many physician groups now suggest starting PSA screening at 50.
Calculating your risk profile can inform when to begin screening. This includes obtaining an accurate assessment for inherited factors, explained Dr. Hulick.
- Traditional family history: Your risk increases if your father had prostate cancer, though not everyone with a family history will develop the disease.
- Single “monogenic” causes: Patients with inherited pathogenic variants in genes (BRCA2, CHEK2 and ATM) also have an elevated risk of developing prostate cancer. This information can also be used to help predict how aggressive cancer may be.
- Polygenic risk score (PRS) test: Sophisticated PRS testing analyzes blood or saliva samples against a population database of genetics to identify the risk for many chronic diseases, including prostate cancer. Endeavor Health is one of the first providers to offer PRS testing to patients. “Recent studies and more awareness of the value of PRS will spark conversations about how and when to move forward with PSA testing, screening and treatment,” added Dr. Hulick, who advises patients to start a conversation with their primary care physician. PRS testing, while not yet covered by insurance, identifies more people at risk of developing cancer than either family history or testing of single monogenic causes.
Colon cancer
As colon cancer cases continue to rise in younger men, the recommended age to begin screening is now 45. “A colonoscopy remains the gold standard for screening and other tests are definitely not recommended for those at higher risk,” said Dr. Hulick.
A family history of colon cancer and pathogenic variants in genes related to Lynch syndrome put people at higher risk of developing certain cancers, including colorectal. “Lynch syndrome is the second most common cause of hereditary cancers, but far less people are aware of it compared to the BRCA mutations,” said Dr. Hulick.
Skin cancer
Annual skin exams are an important way to find and prevent melanomas and other skin cancers. People with fair skin and those with a history of sun burns are at higher-than-average risk for developing skin cancers and should be extra vigilant about looking for changing moles and new growths, as well as seeing a dermatologist for annual exams.
Lung cancer
Lung cancer screening with a low dose CT scan is recommended for people who currently smoke or those who have quit within the last 15 years. Current guidelines suggest annual screening for people with a 20 pack-year history of smoking — a pack year equals one pack per day for a year, smoking two packs a day counts as two pack years and so on.
Oral cancer
Oral cancer screening is another important health check, especially for men with a history of smoking, chewing tobacco or heavy drinking. These screenings are often done during a routine dental exam.
Healthy lifestyle habits to lower risk
In addition to screenings, what else can men do to decrease their risk?
Men (and women) are encouraged to stay on top of recommended screenings, but Dr. Hulick also urges patients to adopt healthy lifestyle habits.
“Knowing your risk is important, but many cancer risks are modifiable,” he said. Not smoking, getting regular exercise and healthy eating are all ways to limit your cancer risks.
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