When you should screen for these 5 cancers

Credit: Getty Images

Credit: Getty Images

To maintain health and wellness, senior adults should maintain a daily routine that includes diet, exercise, and other healthy habits, such as regular doctor visits, preventative health and wellness programs, and cancer screenings to keep one’s overall health in check.

In Your Prime spoke with Dr. Jessica Uhler, MD, of the Premier Physician Network at Premier Health to learn more on the importance of early cancer screenings.

“Routine cancer screenings are a hallmark of primary care, and it’s one of the most important things we do as part of general wellness visits. It’s important to do the screenings and keep up with them, because it helps us catch things early,” Uhler said.

She said identifying potential problems early can help seniors determine the most effective treatments options and outcomes.

“The earlier we catch these cancers, the more treatment options you have, and the better outcomes you have, so it’s better to screen for things, find things, ideally, before symptoms are there, because often, if you’re waiting for symptoms, or signs to show up, things have progressed,” Uhler said.

She said the five common cancers doctors can screen for include breast, colon, cervical, lung and prostate cancers.

Breast cancer

Mammograms are the screening tool for breast cancer, and they are recommended for women of average risk, every 1-2 years from the ages of 40 to 74, and they are strongly recommended for women from the ages of 50 to 74.

After age 75, they are not generally recommended, but that’s a conversation for you to have with your primary care doctor. This is based on average risk, so if women have any family history of breast cancer, or other risk factors, that can definitely change the screening recommendation, so it’s important to keep your primary care physician aware of any family history, and any changes to that.

One new recommendation that we recommend a lot is we do genetic cancer screenings, yearly, with our patients here to make sure we catch any changes in their family history, and depending on that family history, if there’s evidence of breast cancer, prostate cancer, or ovarian cancer, that can qualify you for genetic testing to look for known mutations that can mean you’re at higher risk.

Colon cancer

The recommendations in recent years got decreased to start screening everybody at average risk for colon cancer at age 45. It became younger. So, routine colon cancer screenings are recommended for all adults between the ages of 45 and 75, and there are different options when it comes to Colon cancer screenings.

That’s definitely a conversation to have with your doctor. There’s the colonoscopy, which is the gold standard. It’s a procedure, so it does require more preparation, and it’s a little bit more invasive, but if everything is normal, you are good for 10 years, or if they find something abnormal, they can take biopsies, and treat it right then, and there.

As an alternative, there are stool tests that you take home and take a stool sample and mail off that either check for blood in the stool, or a mixture of blood and DNA, and those are less expensive tests, non-invasive, but they do have to be done more frequently. So, that’s something to ask your primary care doctor about.

Then, obviously, depending on your family history, the recommendations can change, so it’s important to let your physician know about any family history of Colon cancer.

Cervical cancer

Cervical cancer is another cancer we screen for. In general, all people with a cervix should be screened between the ages of 21 and 65. The screening for cervical cancer is with a Pap Smear, and a test for HPV, which is the Human Papillomavirus. It’s the virus that we know can cause cervical cancer.

If you’ve had normal Pap Smears and HPV tests in the past, we recommend keeping up with those every five years, and if the screening for that has always been normal, it stops at age 65.

Lung cancer

This one is specific, and it is a newer screening for adults, ages 50 to 80, who have ever had a 20-pack year smoking history. And what that means is if you smoked one pack a day for 20 years, that would equal a 20-pack year smoking history, or if you smoked two packs per day for 10 years, that’s a 20-pack year smoking history.

So, if you have had that smoking history, and either you currently smoke, or you have quit in the past 15 years, there is a low-dose CT scan that can be done to check your lungs for signs of lung cancer. That is recommended from age 50 to 80 years old.

Once you have quit smoking for 15 years, so say you smoked until age 50, you were doing the yearly CT scans until you turned 65, and you have quit smoking for 15 years at that point, then you stop the screenings, or if you start to have more health issues, where if they found lung cancer, where you wouldn’t be able to go through a lung surgery, then they would stop the screenings. Individuals should have a conversation with their doctor regarding their own screenings and care.

Prostate cancer

While there aren’t specific guidelines about Prostate cancer screenings, there is a blood test called a PSA (prostate-specific antigen level) to screen for Prostate cancer. That blood test can be elevated for many different reasons, not just prostate cancer. It can elevate with age, or if the Prostate is enlarged, or if there’s any infection in the prostate. But we do know that it’s correlated with prostate cancer if it’s higher.

It is generally recommended that a person have a discussion with their physician starting at age 50 for men at average risk to talk about getting that blood test annually, and that’s if you expected to live at least 10 more years. Then, depending on your family history, or if you’re any African American man, or any man who has had a first-degree relative, like father or a brother that has had Prostate cancer, it’s recommended to start that conversation at age 45.

We do know Prostate cancer is more common in African American men, so they are considered to be at a higher risk.

According to the American Cancer Society in 2023, for newly diagnosed cases, the top cancers in men in the United States are Prostate, followed by Lung, and followed by Colon cancer. For women in 2023, the top cancer was Breast cancer, followed by Lung and then Colon cancer. For all of those cancers, there are screenings available.

In addition to consulting with your primary care doctor, the American Cancer Society is one resource for those who have questions about what’s recommended for screenings and the guidelines.

Don’t put screenings off

“A lot of people put off screenings due to fear of the unknown, not wanting to find out something bad,” said Uhler. “And unfortunately, monetary, sometimes is a reason why people put things off.”

Most insurance plans and Medicare should cover these recommended preventative screenings, but there can still be costs involved for mammograms and colonoscopies, so it’s always important to check with your health system about the expected cost, and also check with your insurance plan.

Reducing cancer risks

“Overall, reducing risk is about leading a healthy lifestyle, eating healthy, being active, and keeping up with your regular wellness visits with your primary care doctor,” Uhler said.

As we age, important things to keep doing are to keep physically, socially, and mentally active, she said.

To keep physically active, you should get regular exercise, at least 150 minutes a week. Keeping socially active might mean talking on the phone with friends or going to dinner. A mental activity might be doing a crossword puzzle, Sudoku, or reading.

Early detection is key

Uhler said early detection is key in oncology treatment. When you find things early, there are more treatment options, usually. For example, if Colon cancer is found early enough, the treatment can just be surgery alone, where they remove the tumor, and you may not need chemotherapy or radiation at all. It’s just something that they monitor with repeat colonoscopies and scans.

“The matter of early detection can really guide your treatments and can mean not needing chemo or radiation, which would be ideal,” she said.

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