Early detection of cancer in men: Screening recommendations

According to Globocan 2018 data (a research on incidence, mortality rate and prevalence of 36 types of cancers in 185 countries), the five most prevalent cancers in Indian men are those of mouth, lung, stomach, colon and esophagus (food pipe). Lung and oral cancer together account for over 25 per cent cancer deaths among men in India. Fortunately, these most cancers can be prevented through early screening and detection.
Due to the absence of significant symptoms which mostly go unnoticed, a large majority of cancer patients often seek medical intervention at an advanced or later stage when the disease becomes incurable.Only solution to this lies in timely and effective screening.
One must have a thorough discussion with their doctor before undergoing any form of screening to understand its risks and benefits. Genetic predisposition (genetic susceptibility) determines the right age and type of screening to be undertaken.
Lung cancer screening
Lung cancer is one of the leading causes of cancer-related deaths, globally. Though the ones at the highest risk are current or former smokers, it can also affect those who don’t smoke. Apart from smoking, air pollution is one of the biggest causes of this disease. Lung cancer is often diagnosed at an advanced stage, with poor resultant outcome. Therefore, screening becomes crucial for timely prevention or treatment.
Men aged between 55-75 years can undergo screening for lung cancer, especially if they are or were heavy smokers. The screening is conducted annually through a low-dose CT scan (LDCT) of the chest to help identify early stage lung cancers.
Oral cancer screening
Oral cancer refers to the cancer of lips, tongue, cheeks, floor of the mouth, hard and soft palate, and pharynx (throat). Those who regularly consume tobacco (smoking and chewable tobacco) and alcoholics are at a higher risk of developing oral cancer.
Oral cancer is often preceded by a pre-malignant lesion and screening tests are recommended for high-risk adults with this symptom. A simple visual inspection can help detect premalignant conditions.
Prostate cancer screening
Prostate cancer affects the prostate gland which produces some of the fluid in semen and helps in controlling urine in men. Its incidence increases with age. The disease in its early localized stages can be treated through surgery and radiotherapy. Screening must begin from the age of 50 years and is done through a blood test called prostate specific antigen (PSA) test. If the PSA test is abnormal, further scans and a biopsy is recommended for confirming prostate cancer.
Colon cancer screening
Colon cancer, commonly referred to as colorectal cancer begins as non-cancerous clumps of cells called polyps in the large intestine which can over time develop into colon cancer. Men above the age of 50 years should routinely undergo screening for colon cancer and this should continue until the age of 75 years. Screening is also recommended for younger individuals with personal or family history of cancer, polyps, past exposure to radiation or history of inflammatory bowel disease.
Two types of screening are recommended for colon cancer - one that screens for both cancer and polyps, and other that just screens for cancer. Tests used for screening cancer and polyps include flexible sigmoidoscopy, colonoscopy, double-contrast barium enema, or CT colonography (virtual colonoscopy). Tests that primarily screen only for cancer include stool testing for blood, or stool DNA testing.
Many cancers are preventable. Avoiding smoking, consumption of alcohol, maintaining ideal body weight by consuming a balanced diet and being physically active are measures one can take to cut down their risk of cancer.
Dr Jyoti Wadhwa, Director - Head Neck & Thoracic Oncology, Medical and Haemato Oncology, Cancer Institute, Medanta