NU 629 Discussion 1: Men’s Health Planning

Sample Answer NU 629 Discussion 1: Men’s Health Planning for Included After Question

Initial Post

This discussion will allow you to examine several different preventive guidelines related to men’s health. Choose one of the following topics and respond to the thread corresponding to the question you select. Please include at least three scholarly sources within your initial post.

Note: As you are choosing a topic, please try to make sure that all topics are chosen by at least one person. You can see this by noting if anyone has posted to the topic within the corresponding threads.

A Sample Answer For the Assignment: NU 629 Discussion 1: Men’s Health Planning

Title: NU 629 Discussion 1: Men’s Health Planning

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.

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

Topic 2: Prostate Cancer Screening

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.

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

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.

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

Topic 1: Colorectal Cancer Screening

by Katarina Robeniol – Monday, 4 October 2021, 12:26 PM

What are the recommendations and source(s)/options for the colorectal cancer screening test?

The recommendations of different organizations are varied when it comes to the age for screening for colorectal cancer. General consensus states average risk adults age 50-75 should be screened for this. Currently, the U.S. Preventative Services Task Force (or USPSTF) recommends screening for colorectal cancer for adults age 50 to 75 years as there is high certainty that the benefit is substantial. As for adults age 45 to 49 years old, USPSTF provides a screening recommendation, but at a moderate certainty that the benefit is substantial (“Colorectal Cancer: Screening,” 2021).

Nonetheless, the guidelines have expanded to screening adults beginning age 45 for other organizations. For example, the American Cancer Society (ACS) as well as the American College of Gastroenterology recommends those at average risk for colorectal cancer start at age 45 due to studies indicating increased rates of cancer in those younger than 50 (Wolf et al., 2018). The different types of colorectal cancer screening tests include stool based tests (such as fecal immunochemical tests) as well as visual exams (colonoscopy, done every 10 years) (“When Should You Start Getting Screened for Colorectal Cancer,” 2021). 

The patient thinks he does not have to worry about “being screened” until age 50. Is he correct? Why or why not?

Though I understand the patient’s view, in his case he is incorrect about not having to worry about being screened despite his age under 50. As mentioned previously, current screening based on a few organizations have lowered age suggestions in the past few years to begin at age 45 (“What Should I Know About Screening?”, 2021). The CDC and ACS recommends even earlier screening for individuals who have higher risk factors for colorectal cancer.

In this situation, the strongest case in point being the family history of the patient’s uncle who was diagnosed with colon cancer at age 54. In addition to his BMI measurement classified as obese and lack of annual physical checkups, his lifestyle factors may also contribute to an increased risk of the disease (“What Are Risk Factors of Colorectal Cancer,” 2021). 

What age would you recommend screening for this patient and why? Does his family history come into play here?

I would absolutely recommend this man for colorectal cancer screening as soon as possible due to his family history. Initiating screening at an earlier age than recommended based on family history of cancer is a strongly recommended strategy for detecting early-onset colorectal cancer (Gupta et al., 2020). Existing research has shown that having 1 affected first-degree relative can increase colorectal cancer twofold alone. A family risk identified alone is worth an early screen, as insufficient collection of history is often a barrier in identifying individuals who would benefit sooner (Lowery et al., 2016). 

References 

Colorectal cancer: Screening. (2021, May 18). U.S. Retrieved from https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening

Gupta, S., Bharti, B., Ahnen, D.J., Buchanan, D.D., Cheng, I.C., Cotterchio, M., Figueiredo, J.C., Gallinger, S.J., Haile, R.W., Jenkins, M.A., Lindor, N.M., Macrae, F.A., Le Marchand, L., Newcomb, P.A., Thibodeau, S.N., Win, A.K. & Martinez, M.E. (2020). Potential impact of family history–based screening guidelines on the detection of early-onset colorectal cancer. Cancer, 126, 3013-3020. https://doi.org/10.1002/cncr.32851

Lowery, J.T., Ahnen, D.J., Schroy, P.C., III, Hampel, H., Baxter, N., Boland, C.R., Burt, R.W., Butterly, L., Doerr, M., Doroshenk, M., Feero, W.G., Henrikson, N., Ladabaum, U., Lieberman, D., McFarland, E.G., Peterson, S.K., Raymond, M., Samadder, N.J., Syngal, S., Weber, T.K., Zauber, A.G. & Smith, R. (2016). Understanding the contribution of family history to colorectal cancer risk and its clinical implications: A state-of-the-science review. Cancer, 122, 2633-2645. https://doi.org/10.1002/cncr.30080

What are risk factors of colorectal cancer? (2021, February 8). Retrieved from https://www.cdc.gov/cancer/colorectal/basic_info/risk_factors.htm

What should I know about screening? (2021, February 8). Retreived from https://www.cdc.gov/cancer/colorectal/basic_info/risk_factors.htm

When should you start getting screened for colorectal cancer. (2021, February 4). Retrieved from https://www.cancer.org/latest-news/american-cancer-society-updates-colorectal-cancer-screening-guideline.html

Wolf, A.M., Fontham, E.T., Church, T.R., Flowers, C.R., Guerra, C.E., LaMonte, S.J., Etzioni, R., McKenna, M.T., Oeffinger, K.C., Shih, Y.-C.T., Walter, L.C., Andrews, K.S., Brawley, O.W., Brooks, D., Fedewa, S.A., Manassaram-Baptiste, D., Siegel, R.L., Wender, R.C. & 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, 250-281. https://doi.org/10.3322/caac.21457

A Sample Answer 2 For the Assignment: NU 629 Discussion 1: Men’s Health Planning

Title: NU 629 Discussion 1: Men’s Health Planning

What are the recommendations and sources or options for the colorectal cancer screening test? 

Colorectal cancer screening is an important tool for early detection when a person does not have symptoms (Center for Disease Control and Prevention [CDC], 2021). The United States Preventative Services Task Force (USPSTF) recommends colorectal cancer screening in all adults aged 45 to 75 years (U.S. Preventive Services Task Force [USPSTF], 2021). The regular screening guidelines recommend starting at age 45; however, certain criteria such as having a close relative who had polyps or colorectal cancer, inflammatory bowel disease, or a history of familial adenomatous polyposis or Lynch syndrome can increase the risks, and earlier screening is recommended (CDC, 2021).

Some screening test options and intervals are stool-based tests that include high-sensitivity guaiac fecal occult blood test (annually), stool DNA test (one to three years), or fecal immunochemical test (one to three years); direct visual tests such as a colonoscopy (every ten years), flexible sigmoidoscopy (every five to 10 years), or CT colonography (every five years) (USPSTF, 2021). The risks and benefits of each screening tool vary and may include a combination of these screening tests (USPSTF, 2021).

The patient thinks he does not have to worry about “being screened” until age 50. Is he correct? Why or why not

The patient is incorrect because the guidelines from the CDC and USPSTF recommend colorectal screening start at age 45 (CDC, 2021; USPSTF, 2021). Within the past two decades, colorectal screening has contributed to the decline in the incidence and mortality of colorectal cancer (Wang et al., 2021). He has a family history of colon cancer as his uncle was diagnosed at age 54, which can put him at risk. When collecting family history about colorectal cancer risks, including relatives such as uncles and their diagnosis age can help change medical management to prevent cancer or lower risks (CDC, 2021).

However, about 80% of colorectal cancers have been linked to environmental factors such as social, cultural, and lifestyle practices (Tian et al., 2019). His BMI is 30, and obesity is a risk factor for colorectal cancer (Martinez-Useros & Garcia-Foncillas, 2016). In addition, he is complaining about some constipation, which can be a symptom of colorectal cancer (CDC, 2021). Additionally, his history shows he does not receive routine medical care, and his last physical was five years ago. This gap in regular physical exams can impact screening for potential health issues. Therefore, waiting until he is age 50 is not recommended as he has several risk factors.

What age would you recommend screening for this patient and why? Does his family history come into play here? 

This patient should be screened for colorectal cancer as soon as possible. He has multiple risk factors such as family history, obesity, and constipation. A family history of colorectal cancer can be caused by inherited genetic predisposition, shared environmental factors, or both (Tian et al., 2019). A recent study revealed that colorectal cancer in one second degree relative, such as an uncle, showed an association with the risk of colorectal cancer (Tian et al., 2019). Regular screening for colorectal cancer is essential in early detection and prevention.

References

Center for Disease Control and Prevention. (2021). Colorectal cancer. U.S. Department of Health and Human Services. https://www.cdc.gov/cancer/colorectal/basic_info/screening/index.htm

Martinez-Useros, J., & Garcia-Foncillas, J. (2016). Obesity and colorectal cancer: Molecular features of adipose tissue. Journal of Translational Medicine, 14(1). https://doi.org/10.1186/s12967-016-0772-5

Tian, Y., Kharazmi, E., Sundquist, K., Sundquist, J., Brenner, H., & Fallah, M. (2019). Familial colorectal cancer risk in half siblings and siblings: Nationwide cohort study. BMJ, 364, 1–9. https://doi.org/10.1136/bmj.l803

U.S. Preventive Services Task Force. (2021). Colorectal cancer: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening

Wang, K., Ma, W., Wu, K., Ogino, S., Chan, A. T., Giovannucci, E. L., & Song, M. (2021). Healthy lifestyle, endoscopic screening, and colorectal cancer incidence and mortality in the United States: A nationwide cohort study. PLOS Medicine, 18(2), e1003522. https://doi.org/10.1371/journal.pmed.1003522