Cancer death rates have fallen in recent years, and news this month about the advancement of groundbreaking research has stirred optimism for new treatments of melanoma, pancreatic cancer and beyond.
But cancer rates are still rising among younger adults. And researchers have also identified disparities in diagnoses, with a recent study indicating men were more likely than women to be diagnosed at a later stage for 20 types of cancer — including stomach, lung, tongue and some throat cancers.
Beth Maclin, a postdoctoral fellow at the National Cancer Institute who led the study that reviewed health data from 2015-2022, said the disparity may help explain why cancer mortality rates for men are higher than women. The reasons for a late stage cancer diagnosis, when the disease has spread in the body and progressed to a more lethal and less treatable stage, can include not undergoing cancer screenings or regular health checkups, Maclin said.
Some cancers can’t be screened for or are hard to detect until they become life-threatening. But there are many factors that everyone can control to help manage their cancer risk and spot signs of disease before they progress, experts told The Washington Post. Here are their suggestions.
Stay up-to-date on screenings
Experts said everyone should ensure they get screened for several cancers at the recommended ages. The American Cancer Society generally recommends the following tests:
- Cervical cancer screening starting at age 25, for women
- Colorectal cancer screening starting at age 45
- Breast cancer screening, in the form of an annual mammogram between the ages of 45-54, and at least once every two years afterward, for women
- Lung cancer screening starting at age 50, for people who meet certain criteria on smoking history
- Consult with a doctor about possible prostate cancer screening starting at age 50, for men
These guidelines can change if you have a higher risk of certain cancers, and it is important to discuss any family history of cancer with your doctor to determine if you should test for some cancers at an earlier age.
Ian Singer, chief of the department of family medicine at Holy Cross Health, added that screening guidelines can vary between organizations. The U.S. Preventive Services Task Force (the body that plays a key role in deciding what preventative care must be covered by health insurance), for example, recommends cervical cancer screening starting at age 21. It also recommends mammograms for breast cancer every two years for all average risk women between 40 and 74.
“A nuanced conversation with a primary care physician remains important as different physicians may follow different guidelines or have their own practice protocols,” Singer said.
Health authorities and cancer groups are evaluating whether to change or loosen some screening guidelines as early-onset cancers rise. Ernest Hawk, the vice president for cancer prevention at the University of Texas MD Anderson Cancer Center, said that while those guidelines could continue to change, it’s best to stick with what authorities are currently recommending.
“I wouldn’t be surprised if the age to start screening did migrate downward if we’re unable to identify the cause for early-onset cancers,” Hawk added. “That’s one of the biggest questions in the field of oncology at the moment.”
Are some screenings overlooked?
Maclin highlighted screening for lung cancer — the deadliest cancer in the United States — as an important test that not enough people are taking. The guidelines for lung cancer screening are complex; the U.S. Preventive Services Task Force recommends the screening for people who are 50 to 80 years old and have a history of heavy smoking, either actively or in the past 15 years. For people who meet this criteria, the screening, a low-dose CT scan, is usually covered by insurance.
“What the research shows is that there’s limited uptake of lung cancer screening,” Maclin said. “I’m not sure if this is because of limited awareness.”
Some experts have advocated for lung cancer screening guidelines to be loosened. The American Cancer Society recommends anyone aged 50 to 80 with a history of heavy smoking to get screened.
Singer said that men often overlook prostate cancer screening, which can be given easily as a blood test that checks for prostate-specific antigen (PSA), a potential sign of the cancer.
There has been debate over who exactly should be screened for prostate cancer. The test is not definitive, and the American Cancer Society recommends patients discuss the potential risks and benefits of prostate cancer screening with their doctors first rather than recommending routine testing for men of any age.
The U.S. Preventive Services Task Force notes that “many men will experience potential harms of screening, including false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and erectile dysfunction.”
The task force recommends against PSA screening in men 70 years and older. For men ages 55 to 69, the decision should be an individual one, it says. The recommendation is from 2018, and an update to the guidelines is in progress.
Prostate cancer is the second most common cause of cancer deaths for men and kills over 35,000 men a year.
“My approach is that prostate cancer is just so pervasive that [you] might as well just get the PSA test and then worry about the follow up tests later,” Singer said. “Prostate cancer, if you catch it early, it’s highly treatable.”
Checkups
Besides screenings, keeping up on annual checkups with your primary care doctor can also help spot odd symptoms or physical signs of cancer, experts said.
“I have several examples of patients who’ve come to see me just for regular annuals, and I’ve done bloodwork, and some stuff has just shown up a little weird or off, and I’ve worked it up further, and it’s revealed [to be] cancer,” Singer said.
Maclin added that keeping up with your oral health and a regular routine of dental cleanings — most adults are recommended to get a cleaning twice a year — can help guard against oral cavity cancers, which were among the cancers her study found were often diagnosed at a later stage in men.
Pay attention to your body
Beyond tests and checkups, among the easiest and most important precautions people can take are managing their physical health, experts said.
“Things like family history and sometimes exposure to environmental factors and toxins, those are things that we can’t necessarily change or control,” said Jamilia Sly, an associate professor of population health science and policy at the Icahn School of Medicine at Mount Sinai. “But lifestyle is a big one that we all have control over to some extent.”
Staying active, managing your weight and eating healthy help avoid known risk factors for cancer, which research indicates has been associated with obesity, ultra-processed foods and alcohol. Sly also emphasized the importance of not ignoring any unusual symptoms — from an odd stool color, to difficulty urinating, to a mole that changes shape.
A full list of symptoms for various cancers can be hard to keep track of, said Hawk. But it’s worth paying attention to any changes in your body that are out of the ordinary and bringing them to a doctor.
“It’s hard to define a specific set of symptoms to pay attention to,” Hawk said. “But generally, any significant change that lasts for a week or two is probably worth having evaluated.”
The post The screenings and other habits doctors recommend as early-onset cancers rise appeared first on Washington Post.
