General Cancer Screening For Men
Cancer screening tests are designed to find cancer or pre-cancerous areas before there are any symptoms. Generally, this is when treatments are most successful (Learn more about screening tests). Various organizations have developed guidelines for cancer screening for men. While these guidelines vary slightly between different organizations, they cover the same basic screening tests, including those for prostate and colorectal cancers.
During routine health exams (at any age) your healthcare provider may also screen for cancers of the skin, mouth, thyroid, and testes. Not all screening tests are right for everyone. Your personal and family cancer history, and/or the presence of a known genetic predisposition, can affect which tests are right for you and at what age you begin them. Be sure to discuss these with your healthcare provider.
Prostate Cancer Screening
Prostate screening recommendations from the American Cancer Society (ACS) and the National Comprehensive Cancer Network (NCCN) recommend that men discuss the risks and benefits of prostate cancer screening with their care team and make an informed decision about whether to be screened or not. Men at average risk for prostate cancer should have this discussion starting at age 50. Men with a father or brother who had prostate cancer before age 65, and all African American men, should have this talk starting at age 45. If you decide to be tested, you should have a Prostate-Specific Antigen (PSA) blood test with or without a digital rectal exam. How often you are tested will depend on your PSA result and family history.
For more information please see the document, Prostate Cancer: Early Detection.
Testicular Cancer Screening
The majority of testicular cancers occur between the ages of 15 and 45. All men should examine their testicles regularly, be familiar with their normal look and feel, and report any changes to their healthcare provider for further testing. Visit the ACS for a guide to performing a testicular self-exam.
Colon and Rectal Cancer Screening
Most men and women over the age of 45-50 should undergo routine screening for colon and rectal cancer, up until age 75. The American Cancer Society suggests starting screening at age 45, whereas the United States Preventive Services Task Force suggests starting at age 50. Insurance may not cover screening before the age of 50 so you should talk with your provider and insurance company before screening. Testing may be appropriate for younger people with a high-risk personal or family health history.
Options for colon cancer screening can be divided into those that screen for both cancer and polyps, and those that just screen for cancer. Tests that screen for cancer and polyps include flexible sigmoidoscopy, colonoscopy, double-contrast barium enema, or CT colonography (virtual colonoscopy). Tests that screen mainly for cancer include stool testing for blood, or stool DNA testing. Learn more about colorectal cancer screening options on OncoLink.
The "preferred screening" recommended by the American College of Gastroenterologists is a colonoscopy every 10 years. The ACS recommends screening beginning at age 45 (unless you are considered "high risk," see below), using one of the following testing schedules:
Tests that find polyps and cancer:
(Preferred over those that find cancer alone. If any of these tests are positive, a colonoscopy should be done.)
- Flexible sigmoidoscopy every 5 years, or
- Colonoscopy every 10 years, or
- CT colonography (virtual colonoscopy) every 5 years.
Tests that primarily test for cancer:
- Yearly guaiac-based fecal occult blood test (gFOBT)*, or
- Yearly Highly sensitive fecal immunochemical test (FIT) *, or
- Multi-targeted stool DNA test (MT-sDNA), every 3 years*.
*The multiple stool take-home test should be used. One test done by the provider in the office is not adequate for testing. A colonoscopy should be done if the test is positive.
Individuals at higher risk of colon cancer should have screening earlier and potentially more frequently. Individuals at higher risk of colon and rectal cancer include:
- Individuals with a family history of colon or rectal cancer in a relative who was diagnosed before the age of 60.
- Individuals with a history of polyps.
- Individuals with inflammatory bowel disease (Crohn’s disease or ulcerative colitis).
- Individuals with a genetic predisposition to colon or rectal cancer, such as hereditary non-polyposis colon cancer (HNPCC) syndrome or familial adenomatous polyposis (FAP) syndrome.
- Individuals who have had radiation to the belly or pelvic area to treat a prior cancer.
Talk with your provider about your medical history, and which colorectal cancer screening test(s) and schedule are right for you. For more information on colorectal cancer screening from the ACS, read ACS recommendations for colorectal cancer early detection.
Lung Cancer Screening
The American Cancer Society does not recommend tests to check for lung cancer in people who are at average risk. However, they do have screening guidelines for those who are at high risk of lung cancer due to cigarette smoking. Screening might be right for you if you meet the following:
- 50 to 80 years of age and in fairly good health.
- Currently smoke or have quit within the past 15 years.
- Have at least a 20 pack-year smoking history (A pack-year is the number of cigarette packs smoked each day multiplied by the number of years a person has smoked. Someone who smoked a pack of cigarettes per day for 20 years has a 20 pack-year smoking history, as does someone who smoked 2 packs a day for 10 years).
- Have gone through smoking cessation counseling if they are current smokers.
Screening is done with a yearly low-dose CT scan (LDCT) of the chest. If you fit the list above, you and your provider should talk about whether you want to start screening. There are risks, benefits, and limitations to low-dose CT scans that you should discuss with your care team.
Sun Exposure and Skin Cancer Risk
Skin cancer is the most commonly diagnosed type of cancer, and rates are on the rise. However, it is one cancer that in most cases can be prevented or detected early. While you may hear that you need the sun to make vitamin D, in reality, you only need a few minutes a day to do this. Exposure to ultraviolet (UV) rays, either by natural sunlight or tanning beds, can lead to skin cancer. In addition, UV rays lead to other forms of skin damage, including wrinkles, loss of skin elasticity, dark patches (sometimes called age spots or liver spots), and pre-cancerous skin changes (such as dry, scaly, rough patches). Although dark-skinned people are less likely to develop skin cancer, they can and do develop skin cancers, most often in areas that are not exposed to the sun (on the soles of the feet, under nails, and genitals).
You can do a lot to protect yourself from damaging UV rays and to detect skin cancer early. Start by practicing sun safety, including using a broad-spectrum sunscreen (which protects against UVA & UVB rays) every day, avoiding peak sun times (10 am-4 pm when the rays are strongest), and wearing protective clothing such as hats, sunglasses, and long-sleeved shirts.
Examine your skin regularly so you become familiar with any moles or birthmarks. If a mole has changed in any way, you should have a healthcare provider examine the area. This includes a change in size, shape, or color, the development of scaliness, bleeding, oozing, itchiness, or pain, or if you develop a sore that will not heal. If you have a lot of moles, it may be helpful to make note of moles using photographs or a "mole map". The American Academy of Dermatology has a helpful guide to performing a skin exam.
This is a basic guide to cancer screening for men. Each situation is unique. Ask your provider which screening tests are right for you and when you should have them done.