An ounce of prevention is worth a pound of cure. Am I really dedicating the last article in this series (more on that later) to a well-worn cliché? The answer is yes, but with a new twist. Allow me to explain …

Screening is used to identify the possible presence of disease in individuals without signs or symptoms. Therefore, screening tests are performed on persons in apparently good health. The reasoning is that the cost and effort spent on screening and prevention will be less than the cost and effort spent on treating the disease. Some screening programmes are successful, others not so much.

We, as individuals, should participate in screening programmes that have been proven to save lives and prevent disease. Here are some suggestions:

• Colorectal cancer screening. Colorectal cancer is the third most common type of non-skin cancer in both men (after prostate cancer and lung cancer) and women (after breast cancer and lung cancer). It is the second leading cause of cancer death in the United States after lung cancer. The rates of new colorectal cancer cases and deaths among adults aged 50 years or older are decreasing in the US. However, the incidence is increasing among younger adults. Several effective screening methods for colorectal cancer exist and are available in Bermuda.

• High-sensitivity fecal occult blood tests are good screening tests. Both polyps and colorectal cancers can bleed, and FOBT check for tiny amounts of blood in stool that cannot be seen. Currently, two types of FOBT are approved by the Food and Drug Administration to screen for colorectal cancer: guaiac FOBT and the fecal immunochemical test, FIT or iFOBT. With both types of FOBT, the patient uses a kit to collect stool samples and returns them to the doctor.

Guaiac FOBT uses a chemical to detect heme, a component of the oxygen-carrying protein haemoglobin. Because guaiac FOBT can also detect heme in foods such as red meat, people have to avoid certain foods before having this test.

FIT, such as Hemosure, uses antibodies to detect human haemoglobin specifically. Dietary restrictions are typically not needed for FIT.

Studies have shown that guaiac FOBT, when performed every one to two years in people aged 50 to 80, can help reduce the number of deaths due to colorectal cancer by up to 33 per cent. If FOBT is the only type of colorectal cancer screening test performed, the US Preventive Services Task Force recommends yearly testing.

• Other screening methods for colorectal cancer include colonoscopy and sigmoidoscopy, where a doctor inserts a flexible tube with camera into the colon to search for polyps or cancer. The advantage of these tests is that a doctor can remove a polyp or perform a biopsy during the test.

• Prostate cancer screening. A prostate-specific antigen test is a test that measures the level of PSA in the blood. PSA is a substance made mostly by the prostate that may increase in amount in the blood of men who have prostate cancer. The level of PSA may also be high in men who have an infection or inflammation of the prostate or benign prostatic hyperplasia — an enlarged, but noncancerous, prostate. Scientists are studying the combination of PSA testing and digital rectal exam as a way to get more accurate results from the screening tests.

• Breast cancer screening. Mammography is the most common screening test for breast cancer. A mammogram is an X-ray of the breast. This test may find tumours that are too small to feel. Other breast cancer screening methods include a clinical breast examination and breast MRI — an imaging study of the breast.

Screening tests for other diseases are available, but we have limited space in this article. Ask your doctor if you should have a screening test. Often, taking initiative in your own medical care results in significant benefits.

Finally, thank you very much for reading my series on ageing and health. Today’s article is the final piece. Much was said, but more remains to be said on the subject. Therefore, this is not goodbye — rather, this is “until we meet again”.

*Some information for this article has been adapted from the National Cancer Institute.

Mike Serebrennik is a physician by training and now a full-time entrepreneur, investor and writer. He is also a director of product development and sourcing at Lighthouse Medical Supplies, Ltd, a local company dedicated to helping patients and healthcare providers lower the cost and increase the quality of care