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Men Screened More for Prostate Cancer
March 18, 2003 -- While colorectal cancer screens have been shown to reduce the risk of dying from the disease, the same can't be said of the popular prostate cancer screening test. But guess which is more often given to American men?
While 75% of men report having had a prostate-specific antigen (PSA) blood test to screen for prostate cancer, only 63% have ever had any of three primary colorectal cancer detection tests, according to a new study. These include a fecal occult blood test to detect blood in the stool; a sigmoidoscopy, in which the lowest one-third of the colon is examined with a camera fixed on a flexible tube; and the more comprehensive colonoscopy, in which the entire colon and lower intestines are examined.
This finding, published in the March 19 issue of TheJournal of the American MedicalAssociation, is based on data from nearly 50,000 men at least age 40 who participated in an annual national telephone survey conducted by the CDC.
"We were surprised," says lead researcher Brenda E. Sirovich, MD, of Dartmouth Medical School and the Veterans Affair Medical Center in White Junction, Vt. "We expected to find that medical screening practices are more parallel with the evidence of benefit. But we found the reverse."
Though research is under way to investigate the real value of prostate cancer screening in reducing the rate of death from prostate cancer, there currently is no proof it helps. But experts agree that any of the three colorectal procedures can help detect colorectal cancers at earlier stages, where they are most treatable.
In her study, Sirovich notes that in three separate trials involving some 250,000 men, the death rate was reduced as much as one-third among those screened for colon cancer with a fecal occult blood test -- the most studied of the three screenings and the one recommended annually for everyone after age 50.
"Many believe that flexible sigmoidoscopy and colonoscopy will prove even more beneficial," she tells WebMD. That's because in addition to being more thorough screenings, some existing polyps can be removed during these procedures.
Sigmoidoscopy, which takes about 10 minutes and can be done in a doctor's office, examines the lowest one-third of colon -- where 60% of the cancers occur. It is recommended every five years after age 50, sometimes with a fecal blood test. Colonoscopy is an outpatient procedure done under light sedation and takes about one hour to perform, but requires bowel preparation; it can replace the two other screenings when done every 10 years starting at age 50.
A fourth test, a double contrast barium enema, is rarely done these days to detect, but not remove, large polyps. It is typically reserved for the elderly, heart patients, and others who shouldn't be sedated or can't handle either "oscopy."
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