Each year when you visit your primary care provider, you are likely given a list of suggested tests and screenings for early disease detection. Screenings are the tests and exams used to find disease in people who don’t have symptoms. The screening list may be different for all of us, but the two most common screenings are for breast and prostate cancer. The recommendations for breast cancer screenings have been steady over the years. The recommendations for prostate cancer screenings continues to evolve.
Mammograms remain the best tool available for early detection of breast cancer. Although there has been controversy regarding the usefulness of mammograms, the American Cancer Society (ACS) continues to recommend yearly screenings for women over the age of 40. Health insurance carriers are required to ensure women receive a screening mammogram each year at no cost.
Concerns have been raised regarding the amount of radiation exposure received during a lifetime of annual screenings. To put this into perspective, the amount of radiation a woman receives over the period of 50 years of screening mammograms is about 20 to 40 rads (a rad is a 2100 measurement of radiation dose). This dosage is minimal when compared to the 5000 rad dose of radiation a woman receives with treatment for breast cancer.
Mammograms do have limitations, but the value of the screening continues to be supported by strong evidence that confirms the substantial benefit to women in their 40s. The ACS suggests screenings continue for life as long no serious, chronic conditions exist. Experts suggest combining annual mammograms with early clinical breast exams and monthly breast self-exams for best results.
As with all cancers, early detection is key. With prostate cancer, this can be difficult because screening for prostate cancer is less defined than breast cancer screening.
The Prostate Specific Antigen (PSA) and Digital Rectal Exam (DRE) are the two available tests for prostate cancer. Neither of these tests prove cancer does or does not exist, they merely offer warning signs. The PSA measures a substance made in the prostate gland. The chance that prostate cancer is present is higher when the PSA is raised. However, there are many other factors that could increase a PSA (e.g., age, enlarged prostate, certain medications).
While PSA is more effective at detecting prostate cancer, DREs may be more helpful for those with a normal PSA level. For early prostate cancer detection, it is important to watch for symptoms such as difficulty urinating, blood in urine, trouble getting an erection or pain in the back or ribs.
The ACS recommends physicians discuss screening with patients
- age 50 years or older at average risk for prostate cancer who are expected to live at least 10 more years
- age 45 who are high risk for developing prostate cancer. This includes African Americans and men with a father or brother (first-degree relative) diagnosed with prostate cancer under age 65.
- age 40 who are at even higher risk due to more than one first-degree relative with prostate cancer at an early age
For both prostate and breast cancer risks, it is important to talk with your primary care provider (PCP). Your PCP can look at your family history and decide on the best course of action for you.