During screening tests, sign- and symptom-free individuals (belonging to certain risk groups) are screened in order to detect the presence of certain diseases before symptom development.
We tend to pay attention to our health only when we get sick, whereas many diseases start before it gets symptomatic, hence by early detection, some of these diseases are preventable. Regular screening tests help to recognize diseases which develop during years and timeliness (i.e. early diagnosis) is crucial in their successful treatment.
For men, the most important screening tests are:
- prostate screening,
- testicular self-examination,
- colorectal screening,
- bone density screening,
- melanoma screening,
- labworks/blood test,
- cardiac screening tests,
- lung screening,
- ophthalmological screening.
Prostate cancer usually affects elderly men, but it may occur in men above the age of 45. The early stage of the disease is usually symptom-free, then it manifests primarily with urination problems (frequent urination, difficulty starting urination, dripping after urination, pain or burning during urination, blood in urine or semen). It might take years to develop signs and symptoms.
These symptoms are atypical, inflammation of the prostate gland (prostatitis) or prostate enlargement (benign prostatic hyperplasia) may cause similar symptoms, therefore it is important to see a urologist when experiencing these symptoms.
If early detected, prostate cancer can be successfully treated or kept in remission.
For early detection, regular (yearly) screening tests are recommended for men above the age of 45, which include:
- blood test (PSA test) – to determine the level of prostate-specific antigen (PSA) in the blood;
- digital rectal exam (DRE) – short and painless physical examination of the prostate through the rectum;
- ultrasonography (if necessary).
Testicular tumors, if early diagnosed, can be cured in almost 100% of the cases, therefore above the age of 13-15, it is important to perform regular testicular self-examinations, at least once a month. It is advised to perform the self-exam immediately after taking a bath or a shower, because at this time the scrotum is relaxed as a result of general muscle relaxation.
First, place your testicles on your palm and weigh them together, then weigh them separately. It is not necessarily pathological if one of the testicles are heavier than the other, but if you notice a change in their weight, that might be abnormal.
Then, with the help of your thumb and your index finger, gently feel both testes, look for any enlargements or lumps (for those who are not experienced, the epidydimis or the spermatic duct might feel like a small mass). A flexible lump might indicate a harmless collection of fluid in the scrotum that is called “hydrocele”, which can be easily treated.
If you notice any abnormalities during the self-exam (pain, unpleasant feeling or lumps), contact your GP or urologist specialist as soon as possible!
Colorectal cancer is often diagnosed late, since its symptoms are atypical, whereas with early recognition, it can be treated successfully.
Colorectal screening is recommended above the age of 40 for those, who has a family history of colorectal cancer, colorectal polyps or colitis. Above the age of 50 it is recommended for everyone in every second year, since the prevalence of colorectal cancer significantly increases above the age of 50.
The organized screening procedure has two steps. First, a fecal occult blood test (FOBT) is performed. This is a laboratory test used to check stool samples for hidden (occult) blood. The treating physician might also perform a digital rectal exam (DRE), since relatively high number of colorectal cancers present in the rectum.
If the FOBT or the DRE is positive, the doctor refers the patient to a gastroenterologist for a colonoscopy. During colonoscopy, the doctor introduces a fiberoptic-device into the colon via the rectum with which the lumen and the wall of the colon can be examined. Most colorectal cancers are evolved from colon polyps, which can be removed painlessly during colonoscopies.
CT-colonoscopy (abdominal and pelvic CT scan) and capsule endoscopy (that involves the swallowing of a small capsule containing a tiny video camera) can also be involved in the screening procedure.
Bone density screening
Bone density screening (osteodensitometry – ODM) measures the mineral content of bones. Bone density starts to decrease at the age of 50 and the process is faster in women due to hormonal changes occurring with menopause. Performing bone density screening test is advised in every 2nd or 3rd year for those with suspected osteoporosis and for those with risk factors of osteoporosis: inadequate calcium intake, smoking, excessive caffeine intake, sedentary lifestyle, hormonal problems, genetic susceptibility, tall and thin stature, diabetes, liver or kidney disease, and also those who take medications that increases the risk of developing osteoporosis.
The prevalence of skin cancers has been on an increase recently. Melanoma is one of the most malignant diseases, of which risk factors include having a large number of birthmarks (moles, naevi), as well as light skin tone and hair color. Regular dermatological screening visits and self-exams help the early recognition of melanoma and other malignancies, thereby increasing the chance of a successful treatment.
It is advised to have your birthmarks checked yearly by a dermatologist (dermatoscopic screening exam), or every sixth month if you have a large number of birthmarks. Self-exam is recommended to be performed monthly. If you notice a change in the color, size or shape of your birthmark, contact your dermatologist as soon as possible.
The ABCDE acronym stands for the parts of the self-exam:
A: asymmetry – uneven shape.
B: border – melanomas, as contrast to benign skin lesions, tend to have a blurred, asymmetrical borders.
C: color – refers to the pigmentation of the mole. Skin tumors might contain multiple pigments.
D: diameter – if the birthmark’s diameter is larger than 6 mm, that might be alarming.
E: evolving – if the mole changes or increases in size, or if its surface becomes rough and dry or it becomes itchy or starts bleeding, contact a dermatologist.
It is advised to use a sunscreen (Spf 50) in order to protect yourself from the UV rays of the sun and prevent developing skin cancer. It is also recommended to prevent sunburns, if possible.
General blood and urine tests are recommended yearly, but in case of certain diseases it is advised to perform these tests more often. Your GP evaluates the results and decides on whether further exams or medications are necessary.
Cardiac screening tests
The prevalence of cardiovascular diseases is higher above the age of 40, therefore cardiac screening tests are important to detect disturbances in heart function. The doctor performs a complex risk calculation considering individual risk factors (obesity, smoking, hypertension, hypercholesterinemia, sedentary lifestyle, etc.).
The screening can be complemented with other exams, such es ECG, holter ECG, ABPM and if necessary, the GP refers the patient to a cardiologist specialist.
Lung screening is advised in every 3-5th year, above the age of 40, in order to detect lung cancer, especially in smoking individuals. The screening test, however, is not able to detect early-stage cancers, therefore low-dose CT scan is recommended for those with increased risk for lung cancer.
Regular ophthalmological screening visits are recommended even for asymptomatic patients, because they can detect abnormalities that develop symptoms only at later stages, such as diabetes or hypertension.
The screening involves visual acuity and color vision tests, and microscopic eye exam.
Other screening tests recommended for men above the age of 45:
- carotid artery Doppler exams (to detect atherosclerotic lesions);
- detection of tumor markers from blood samples (if malignant disease is suspected, though these tests are advised to be requested by a specialist).