Definition
Testing a person in apparently good health but who has already developed early cancer somewhere in the body. The objective is to find the disease at an early stage to increase the chances of cure.
Which cancers do we screen for and from what age?
It is important to understand that there are still no universal consensus criteria for cancer screening. I always discuss, and then offer where appropriate, screening for the following cancers as part of a comprehensive health check:
Prostate cancer
Although screening for this cancer remains somewhat controversial, I recommend it as there have been very significant advances in diagnostic accuracy (ie distinguishing between prostate cancers that are likely to kill you and those that aren’t), surgical techniques (including the ‘nanoknife’), and pre- and post-operative management of sexual function and urinary continence.
In the vast majority of men, aggressive prostate cancers remain silent until they have spread to other parts of the body, commonly the bones.
The age at which to start screening varies according to family history and other risk factors.
The first discussion on when to start prostate cancer screening should take place at age 40. In most men without a family history of prostate cancer, it is reasonable to start screening from age 45. The subsequent frequency of screening is then discussed on a case-by-case basis.
Testicular cancer
Unlike other cancers, most cases of cancer of the testis occur in men 15-45 years, and in this age group it is the second most common cancer after melanoma.
Bowel cancer
The two main screening techniques available are testing for microscopic blood in the stool (‘faecal occult blood testing’) and colonoscopy.
When to start screening for bowel cancer and which technique to use varies greatly depending on family history and risk factors. Excluding the less common inherited forms of bowel cancer (eg HNPCC, FAP), the first discussion on when to start bowel cancer screening should take place at age 40.
Skin cancers
The age at which to start screening varies greatly according to risk factors and family history of melanoma. But screening should not start any later than age 40.
Screening for cancers other than those listed above should be discussed on a case-by-case basis.