Colorectal Cancer Screening Essay

This discussion will allow you to examine several different preventive guidelines related to men\'s health. 

CHOOSE ONE OF THE FOLLOWING TOPICS for the discussion AND ANSWER THE QUESTIONS

Please include at least three scholarly sources within your initial post.

TOPIC 1: COLORECTAL CANCER SCREENING
A 47-year-old man presents to your clinic for a routine physical. He considers himself to be “fairly healthy” and doesn’t routinely go to the doctor. His last physical was five years ago. In reviewing his chart, you see that his BMI is 30, he exercises twice a week at the local gym, and he does not take any medication. Part of your discussion during today’s visit is about screening for colorectal cancers. He did endorse some constipation in the review of systems. He noted an uncle in his family history who was diagnosed at age 54 with colon cancer. You begin to talk about colorectal screening, and the patient interrupts you and tells you that he is only 47 and that he should not have to worry about it until he is 50.

What are the recommendations and source(s) for the colorectal cancer screening test?
The patient thinks he does not have to worry about “being screened” until age 50. Is he correct? Why or why not? What age would you recommend screening for this patient and why? Does his family history come into play here?
What age would you recommend screening for this patient and why? Does his family history come into play here?
What are the screening options for this patient, and which would you recommend? Why?

TOPIC 2: PROSTATE CANCER SCREENINGS
Your patient is an otherwise healthy, white 55-year-old man who presents for his annual physical. He has a history of hypertension and takes Losartan 50 mg daily. His family history is negative for cardiovascular disease or cancer. His review of systems is negative. The patient is a paramedic and exercises regularly. The patient’s BMI is 23. He states that one of his friends was diagnosed with prostate cancer and asks if he needs to be screened.

Which screening guidelines would you utilize?
Keeping the guideline you used in mind, explain and provide rationales for whether you would change your recommendations if:
The patient had a family history of prostate cancer.
The patient was African American.
The patient was 76 years old.   Colorectal Cancer Screening Essay.

TOPIC 3: TESTICULAR CANCER SCREENING
A 35-year-old African American male is being seen for a pre-employment physical. His father was recently treated for prostate cancer. His BMI is 24, and his past medical history was negative except for an appendectomy 15 years ago. He states he is too young to be screened for prostate cancer, but he wants to be screened for testicular cancer.

What are the primary risk factors for testicular cancer?
What are the screening options for testicular cancer, and which guidelines did you utilize?
Is screening recommended for this patient, and how would you counsel this patient?

Topic 1: Colorectal Cancer Screening

A 47-year-old man presents to your clinic for a routine physical examination. He considers himself to be fairly healthy and does not routinely go to the doctor- his last physical was five years ago. In reviewing his chart, you see that his BMI is 30, he exercises twice a week at the local gym, and he does not take any medication. Part of your discussion today’s visit is about screening for colorectal cancers. He did endorse some constipation in the review of systems. He noted an uncle in his family history who was diagnosed at the age of 54 with colon cancer. You begin to talk about colorectal screening and the patient interrupts you and tells you that he is only 47 and that he should not have to worry about it until he is 50.

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Why the Patient Should Screen Before 50 Years

Age is a significant risk factor for colorectal cancer.The lowest incidence is lowest at 20-24 years and increases gradually to the highest for people older than 85 years of age. However, the incidence of large bowel cancer is rare before the age of 40 years. The incidence increases significantly between the age of 40 and 50 years—age-specific rates of development of colorectal cancer increase every subsequent decade after that (Peterse et al., 2018). Although the exact cause is unknown, risk factors are known. Recent data by Wolf et al. Colorectal Cancer Screening Essay.  (2018) indicates that colorectal cancer incidences are increasing among people aged below 50 years in the United States. The data shows rising incidence even in adults aged between 20 to 39 years and that the rate in this age cohort is lower than for people aged 5o years and over. The Majority (86%) of adults diagnosed with colorectal cancer at ages below 50 years are symptomatic. With that said, screening the 47-year-old man before he reaches 50 years old can help rule out cancer before it advances.

Recommendations for Colorectal Cancer Screening

Most current guidelines do not provide recommendations on screening for asymptomatic people under 50 years old. Current guidelines propose that individuals with a positive family history are eligible for screening. Besides, individuals with predisposing inherited syndrome should also undergo screening even before the age of 50 years. The ACS (American Cancer Society) acclaims colorectal cancer should start at 45 years of age because it is at this e that people have average risk. The American Cancer Society’s current efforts aim to reduce young adults’ colorectal cancer incidence by identifying eligible people for early age surveillance (Wolf et al., 2018). The patient in the scenario should be screened as an individual at average risk. The reason for screening him under this recommendation is that his family history predisposes him to cancer development. Colorectal Cancer Screening Essay.  His BMI of 30 also contributes to the increased risk. This average risk group’s available tests are; fecal immunochemical test for blood, Guaiac-abased fecal occult blood test, and multi-target stool DNA test. Endoscopic visualization via colposcopy sigmoidoscopy and colon capsule endoscopy can be done for average-risk patients (Wolf et al., 2018).

Does Family History Come To Play?

Family history is a vital factor that can influence the development of colorectal cancer. Besides, family history influences screening recommendations. The risk is higher in individuals with inherited conditions. The hereditary conditions or syndromes include Lynch syndrome and familial adenomatous polyposis. In the United States, at least 35 of the young adult cancer associates with hereditary colorectal cancer in the family. The patient in the scenario has a family history of cancer – his uncle was diagnosed at 54 years with colon cancer.

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Rawla et al. (2019) highlight that; a positive colorectal cancer familial history among first and second-degree relatives from either side increases the risk. Familial colorectal cancer results from the interaction between lifestyle and genetic factors. Lifestyle factors such as exercise, diet, obesity, and smoking are significant risk actors. The patient in the case scenario is obese. Low socioeconomic status is also associated with a high risk of colorectal cancer. Study findings show that low rates of colorectal screening contribute to the patient’s and family’s socioeconomic status. Sedentary life independent of obesity and exercise has been associated with the early onset of colorectal cancer. Colorectal Cancer Screening Essay.References

Peterse, E. F., Meester, R. G., Siegel, R. L., Chen, J. C., Dwyer, A., Ahnen, D. J., … & Lansdorp‐Vogelaar, I. (2018). The impact of the rising colorectal cancer incidence in young adults on the optimal age to start screening: microsimulation analysis I to inform the American Cancer Society colorectal cancer screening guideline. Cancer, 124(14), 2964-2973.

Rawla, P., Sunkara, T., & Barsouk, A. (2019). Epidemiology of colorectal cancer: Incidence, mortality, survival, and risk factors. Przeglad gastroenterological, 14(2), 89.

Wolf, A. M., Fontham, E. T., Church, T. R., Flowers, C. R., Guerra, C. E., LaMonte, S. J., … & Smith, R. A. (2018). Colorectal cancer screening for average‐risk adults: 2018 guideline update from the American Cancer Society. CA: a cancer journal for clinicians, 68(4), 250-281.  Colorectal Cancer Screening Essay.