Why Cancer Is More Dangerous in Men

By Ann Matturro Gault

Reviewed by QualityHealth's Medical Advisory Board

Men are notoriously bad guardians of their health. A survey of more than 2,000 men conducted by the American Academy of Family Physicians (AAFP) in 2007 revealed that 55 percent of all men have not seen their primary care physician for a physical exam within the past year.

That attitude in part may explain why the average life expectancy of men is nearly five years less than women (75.4 years compared to 80.4 years). "One of the biggest obstacles to improving the health of men is men themselves," said the AAFP's Rick Kellerman, MD, in a press release. "They don't make health a priority."

Not getting screening tests is another part of the problem. According to the CDC the second leading cause of death for men is cancer—in particular skin cancer, lung cancer, prostate cancer, and colorectal (colon) cancer.

In addition to getting regular exams, knowing your family medical history, living a healthy lifestyle, and having cancer screening tests can also help extend your life. The results of a screening test can help doctors detect cancer cells in early stages when they are most treatable.

Screening tests are especially important as men age since the single greatest risk factor for developing cancer is aging. The American Society of Clinical Oncology says over 60 percent of cancers occur in people over 65.

However, some screening tests—including lung and prostate cancer—are controversial. Knowing your medical history is vital as it gives your doctor the tools to personalize your risk-reduction strategy and determine which tests you need.

Here's what you need to know about cancer screening tests:

Skin Cancer

Skin cancer is the most common cancer among men over age 50. Melanoma is the deadliest form of cancer. One in 41 men—in particular white men over 50—will be diagnosed with melanoma in their lifetime according to the Skin Cancer Foundation. Exposure to ultraviolet radiation (UV) is associated with about 90 percent of non-melanoma skin cancers and 65 percent of melanomas.

Performing monthly skin self-exams and making careful note of changes in the skin along with visiting a dermatologist yearly (or more often depending on your sun exposure and past history) will go a long way toward detecting melanoma in its early stages.

Skin cancers are detected with skin biopsies. To protect your skin from the harmful effects of the sun, The Skin Cancer Foundation recommends you use a sunscreen with an SPF of 15 or higher everyday. In addition, avoid the sun between 10:00 a.m. and 4:00 p.m.; avoid tanning and UV tanning booths; and for extended outdoor activity use a water-resistant, broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher.

Additionally, it's important to apply one ounce (two tablespoons) of sunscreen to your body 30 minutes before going outdoors and to reapply every two hours or immediately after swimming or excessive sweating.

Lung Cancer

Screening tests for lung cancer include chest X-rays; sputum cytology (looking for cancer cells in mucus with a microscope); lung biopsies; and spiral (helical) CT scans of the lungs. However, there is currently no generally-accepted screening test for lung cancer.

Men at high risk of developing lung cancer include smokers and individuals who have been exposed to occupational toxins. Experts aren't sure if the benefits of screening outweigh the potential harms since there is little evidence that screening tests actually prevent people from dying of lung cancer.

Screening for lung cancer can be non-definitive and result in a great deal of anxiety. It's important to consult with a physician to determine if testing is necessary.

Prostate Cancer

The American Urological Association recommends that men age 40 and older talk to their doctors about prostate cancer testing. The prostate is a gland that forms part of the male reproductive system. Prostate enlargement is a common part of aging. A Digital Rectal Examination (DRE) is usually the first test done. This helps a doctor gather information about the size and condition of the gland.

In addition, a doctor may recommend a PSA blood test. Some of the cells in the prostate gland produce PSA, a protein that helps keep semen in its liquid state. Some of the PSA eventually gets into the blood stream. A high PSA reading could be an indication of some kind of prostate condition, including cancer. Some studies have shown PSA levels to fluctuate largely as well.

Much remains unknown about the interpretation of PSA levels and the test's ability to discriminate cancer from benign prostate conditions. In 2010, the American Cancer Society updated its guidelines for the early detection of prostate cancer stating that men should receive information about the benefits, risks, and uncertainties associated with the screening to make an informed decision. African American men and men with a family member—father or brother—diagnosed with prostate cancer before the age of 65 are at increased risk of developing the disease.

A biopsy for prostate cancer can have many undesirable side effects including erectile dysfunction, incontinence, bleeding, infection, and other complications. Getting a baseline PSA reading at age 40, however, is recommended by the AUA.

Colorectal (Colon) Cancer

According to the CDC, colon cancer is largely preventable through screening. Screening is recommended for men and women beginning at age 50 and every five to ten years after.

Screening tests for colorectal cancer can find precancerous polyps. They can be removed before they become cancer. People with a family or personal history of polyps or colorectal cancer, inflammatory bowel disease, or certain genetic syndromes such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer should talk to their doctors about screening earlier or more often than others.

There are many tests that find polyps and cancer which include: