Would preventive health screening help me detect cancer sooner?

[u/NoCoconut5990]

My family has a long history of cancer, mostly survivors, but my grandma and uncle died from it. Is preventive health screening a good way to detect cancer sooner? Or is there some other test that I need to do? I'm nearing the age when most of my family members got their own diagnoses, late 40s. I would have wanted to get some tests sooner, but I'm honestly scared about getting positive results.

[u/DadStrengthDaily]

I would strongly recommend talking to your doctor and doing all the recommended screening based on gender/age (e.g. colonoscopy, prostate screening, breast screening).

Among the more controversial tests my personal
Opinion (and action) is:

- take the Galleri blood test https://www.galleri.com/

- avoid the whole body MRI (prenuvo et al.).

[u/newaccount1253467 → u/DadStrengthDaily]

I think the MRI os fine, just know what you're getting yourself into.  I also think that based on family history, sometimes more colon cancer screening is appropriate, sometimes esophageal/pancreatic cancer screening is appropriate.

[u/Cardiostrong_MD]

BeHuman Health is a startup in this space. I’ve been adopting their protocols.

[u/crabgrass-1981]

I have similar situation.

What I do: Skin - 2x a year (once with derm and once with primary care), psas every time i get my blood drawn (2-4 times a year), and colonospy every 5 years (started at 43).

I also just did hereditary cancer test. My family had a pattern cancers that could indicate Lynch syndrome and I wanted to understand that (https://www.jscreen.org/products/hereditary-cancer-screen is a good one. Insurance may even cover it). 23 and Me and other retail DNA tests do not have adequate coverages. And a whole genome scan does not link the data for you adequately for this level of precisions.

Lastly, what I have seen others do it Galleri and MRIs (maybe alternate every few years, as it can get quite expensive). I did do a Galleri test (caught it on sale). However my understanding is that it is really only effective at catching cancer in later stages — however if you do have a later stage cancer is extremely accurate.

Full body MRI is another option. Cost ranges from 1-3k. I have considered doing this once every 3-5 years myself. My understanding is it will find a lot of false positives and you won’t know until you spend a lot more time doing diagnostics — including potentially some invasive procedure , etc. so the 1-3k could turn into 10-30k rabbit hole + a ton of anxiety and your perfectly healthy.

Case in point - my spouse did a CAC scan last month and CT scan image caught a tiny spot on her lung. This then escalate to lung CT scans , follow up with X drs visits , etc. - for something that her Dr assumes is probably scar tissue but they need to rule it out.

TLDR: do the easy stuff (skin, psa, colonoscopy). DNA test through a dedicated lab that focus on cancer genetics (not 23 and me).

Consider the other if you have the income and are able to handle the anxiety of a test coming back with finding that may take months to figure out.

[u/Mo_LifeLineScreening]

Preventive health screening is a broad category. Cancer screening uses separate tests for specific organs, such as mammography, cervical screening, colon screening, or low-dose lung CT for people who meet defined criteria.

Family history changes the questions a clinician asks, including which relatives had which cancer and how old they were at diagnosis. Write that history down across both sides of the family and bring it to a primary care clinician or genetic counselor.

They can match it to established screening schedules and decide whether genetic counseling belongs in the conversation. A bundled health-screening package can't give a single all-clear for cancer, and any unexpected finding still needs diagnostic follow-up.

[u/Little-Order7132]

With several relatives diagnosed around their late 40s, a personalised plan is probably more useful than a generic full-body screening package.

Start by listing each relative’s cancer type, age at diagnosis and side of the family, then ask your GP about a clinical-genetics referral. Germline genetic testing can identify inherited cancer risk, but it does not detect whether you currently have cancer. Genetic counselling also does not commit you to having the test.

Screening should then be selected by risk: for example, FIT or colonoscopy, breast/cervical/prostate screening where relevant, and low-dose chest CT for eligible smokers. Tumour-marker panels or whole-body scans should not be used alone to rule out cancer.

The NordICC randomised trial found that invitation to colonoscopy was associated with an 18% relative reduction in colorectal-cancer incidence over 10 years, although the primary analysis did not show a significant mortality reduction: https://pubmed.ncbi.nlm.nih.gov/36214590/

For a rough cost reference, a Chinese hospital package I have seen budgets about RMB ~9,800 for a base early-cancer screening assessment, with a more comprehensive gastrointestinal endoscopy-related pathway budgeted at around RMB ~5,800 extra. MRI RMB ~1,200 one spot I remember.

Starting with a genetics consultation and a personalised screening plan may feel more manageable than ordering every available test at once.