Planning preventive care

There are multiple health screenings for both males and females that are essential for detecting cancer.

Colon cancer screening

Colon cancer screening typically starts at age 45 for males and females. The two main colon screenings are a colonoscopy or a DNA stool test called Cologuard. When there is a parent or sibling that had colon cancer, then screening starts at age 40 or 10 years earlier than that relative’s age of diagnosis.

The colonoscopy is the gold standard screening since it can evaluate for multiple abnormalities. If the colonoscopy is normal, then repeat testing does not need to take place for another 10 years. One of the common abnormalities on a colonoscopy is called a colon polyp, which is an abnormal growth inside the lining of the colon.

If a colon polyp is detected, then colonoscopy screenings will be every 5 years. Also, if a parent or sibling had a colon polyp at age 60 or less, then one should investigate what kind of colon polyp it was. For advanced colon polyps, meaning 3 or more polyps or a polyp greater than 1 cm in size, screening would start at age 40 or 10 years before the earliest diagnosis.

Regarding the DNA stool test called Cologuard, I generally recommend this test when there is no family history of colon cancer or in a younger age group. If the Cologuard test is normal, then repeat testing is every 3 years. However, an abnormal Cologuard test would require a colonoscopy.

Prostate and testicular health

All males should consider screening for prostate and testicular cancer. The main way to check for prostate cancer is through a blood test called PSA levels, which starts at age 45. This test checks for a protein elevation in the prostate gland. If there is a parent or sibling that was diagnosed with prostate cancer, then we start screening at age 40. For testicular cancer, the most common age of diagnosis is between 20 to 40 years old. The screening consists of monthly home testicular exams and the warning sign would be a painless lump that feels heavy.

Breast cancer screening

Females should screen for breast and cervical cancer as well as osteoporosis. Breast cancer screening is evaluated through 3D mammogram imaging, which starts at 40 years old and needs to be completed annually. When there is a parent, sibling, or multiple maternal family members that were diagnosed with breast cancer, then the screening may start earlier than 40 years old.

In order to determine if the patient should begin mammograms earlier, patients complete the health questionnaire called the Tyrer-Cuzick Risk Calculator. If the Tyrer-Cuzick score is 20% or more, then screening needs to start prior to 40 years old. It is strongly recommended for women to conduct monthly home breast exams and annual clinical breast exams.

Cervical cancer screening

Cervical cancer screening is evaluated through a PAP smear, which starts at 21 years old. A pap smear involves collecting a small sample of cells from the cervix. If the pap smear is normal, then the screening would be every 3 years.

Bone health and osteoporosis

Another important evaluation for females that are 65 years or older, is to have a DEXA/bone scan screening for osteoporosis completed every two years. Osteoporosis is a condition when the bones become weak and often leads to joint fractures. The best ways to prevent osteoporosis is to consume a daily vitamin D and calcium supplement, perform weight bearing exercises, and avoid smoking or heavy alcohol use.