By Carly Gerretsen
As October and breast cancer awareness winds down and we go into “Movember” for men’s health awareness it is a good time to reflect on screening and prevention of all cancers. A recent study released by the New York State Department of Health (NYSDOH) identified elevated cancer incidence in the East Buffalo/Western Cheektowaga area of Erie County. Researchers assessed cancer rates, and potential contributing factors such as sociodemographic, behavioral, occupational, and environmental factors. Higher than expected rates of six cancers (colorectal, kidney, prostate, oral, esophageal, and lung) were observed in the 50-64-year-old age group. A public hearing was held in late October to discuss the findings and review their recommendations to promote prevention and treatment.
So, what were some of those key findings? Esophageal cancer was 71% higher than expected in the Buffalo area, lung cancer was 25% higher, colorectal 40%, prostate 49%, and kidney 69% higher. Tobacco usage was found to be a likely contributing factor for oral, esophageal, lung, colorectal, and kidney cancers. Excessive alcohol use was associated with oral, esophageal, and colorectal cancers. Obesity and lack of physical activity was associated with esophageal, lung, colorectal, and kidney cancers. Recommendations to address the elevated cancer rates included tobacco cessation, reduced alcohol consumption, healthy diet, increased physical activity, and cancer screening.
Screening is testing for a disease when there are no symptoms or evidence of disease. Screening is necessary to detect early stage cancers such as lung, colorectal, breast, prostate, and oral cavity cancers when treatment may work better. The U.S Preventative Services Task Force (USPSTF) is an independent panel of experts in disease prevention. They make evidence-based recommendations about preventative services.
Lung cancer often has no symptoms until it is late stage. The USPSTF recommends low dose CT scans annually in high risk adults to monitor for early stage lung cancers. You are considered high risk if have a history of heavy smoking, smoke now or quit in the last 15 years, and are age 55-80. Screening can stop once an adult has not smoked for greater than 15 years.
Screening for colorectal cancer should start at age 50 and includes testing for blood in the stool, and a colonoscopy or sigmoidoscopy. The frequency of testing will depend on what is found during the procedure, but often will only need to be completed every 10 years. There is currently not enough evidence to support the use of take-home DNA testing such as Cologuard.
Women of average risk age 50- 74 should get a mammogram every two years. In July 2016, NYS passed a law preventing most health insurance plans to require copays or other out of pocket expenses for screening. Erie County Medical Center in partnership with the American Cancer Society participates in the NFL/Breast Health Equity program with a primary goal of increasing breast cancer screening rates. The program aids with scheduling appointments, paying for transportation costs, and education for women in need of mammograms. The ECMC mobile mammogram bus offers convenient access to state-of-the-art imaging in a neighborhood near you or on the ECMC campus.
Men ages 55-69 should undergo prostate cancer screening. The ECMC Center for Urology Care is dedicated to increasing screening for all men at risk for prostate cancer. A blood test called a prostate specific antigen (PSA) in conjunction with physical examination is the standard method for prostate cancer screening. A high PSA can indicate that there is a prostate condition, but it may not always be cancer. Many factors can impact a PSA test including age, race, certain medical procedures, and medications. Therefore, it is important that you seek guidance from a medical professional familiar with current recommendations and guidelines.
Oral cavity cancers (cancers of the mouth, tongue, lips, and throat) are mostly caused by tobacco, excessive alcohol use, and the HPV virus. HPV vaccination can reduce the risk of cancers of not only the oral cavity, but of the cervix, and anus. The ECMC oral cancer screening study is designed to detect cancers at the earliest stage. Anyone who smokes cigarettes, uses tobacco products, or drinks alcohol has an increased risk of oral cavity cancer and can participate in the study. Your mouth will be examined by a special dentist who specializes in cancer care under both white light and a special blue/green light to look for any abnormalities. If a lesion is found, a biopsy can be completed during the same visit. Discuss your concerns with your regular dentist, or if you don’t have one, you can schedule an appointment in the ECMC dental clinic.
What else can you do to reduce your risk? Eat a healthy, balanced diet that includes fresh fruits, vegetables, and whole grains. Control your weight and drink healthy beverages avoiding fruit juices, sugary drinks, and soda. Use sunscreen, wide brim hats, and UPF clothing. Get the Hepatitis B vaccine. Have a discussion with your family to discuss their health history. Some cancers are genetic and knowing their history may help determine your risk.
Always talk to your primacy care doctor about your health, your risks, your family’s health, and your concerns. Having an open honest relationship with your doctor will give them and you the best chance for identifying cancer or other diseases early. If you don’t have a primary care physician, ECMC can help. We offer a wide range of primary care, specialty, and dental services. You can see your primary care physician, get your mammogram, clean your teeth, stop by for a CT scan, and grab some fresh fruits and vegetables at the ECMC Community Market during the summer.
So “put on your pink” (for breast health month), grow your mustache (for men’s health month), and come get screened.
Carly Gerretsen, DNP, RN, FNP-C, RNFA, is the Director of Oncology Outpatient Operations at Erie County Medical Center.