When Worry Wins, Men Skip the Screening

“Anxiety is a meteor shower of what-ifs”  -Max Lucado

More than 2 million new cases of cancer were diagnosed in the United States in 2025,¹ and nearly 39% of people will face a cancer diagnosis in their lifetime.² Over the past several decades, expanded screening and treatment advances have reduced mortality, with 5-year survival improving from 49% in the mid-1970 to a historic high of 70% today.¹  Early detection is key to this improved prognosis, and routine screening can raise 5-year survival rates for many cancers to over 90%.¹

Despite these benefits, the overwhelming majority of people in the US delay or avoid recommended health screenings.³ Men, in particular, are less likely to seek medical care,⁴ and fewer than half undergo routine health screenings.⁵ A major barrier is worry: 73% of US adults report anxiety about cancer screenings, including fear of bad results,  pain or discomfort, and unexpected costs.⁶ Addressing this anxiety is critical to improving screening rates and outcomes.

PAs are well positioned to help reduce the anxiety barrier through patient education. A survey from the Prevent Cancer Foundation found that 73% of people are more likely to schedule routine cancer screenings when advised about the benefits of early detection.⁶ Three key screenings for men that PAs should address include:

1. Prostate Cancer Screening
   Screening in average-risk patients should begin at age 50 with shared decision-making. High-risk men (Black ancestry, germline mutations, strong family history) should start at age 40.⁷ Screening uses prostate specific antigen or PSA testing, and early detection has reduced metastatic disease at time of diagnosis.⁷

2. Colorectal Cancer (CRC) Screening
   Screening should start at age 45.⁸ Options traditionally included stool-based tests or colonoscopy, but FDA-approved blood tests are now also available. Early detection lowers mortality, with >90% 5-year survival when cancer is localized.⁹

3. Lung Cancer Screening
   Annual low-dose CT of the chest is recommended in adults aged 50-80 with a ≥20 pack-year smoking history who currently smoke or quit within 15 years.¹⁰ Screening significantly reduces lung cancer mortality.¹⁰

PAs and additional health care providers can further improve screening uptake by offering less invasive options and providing support. One study found that 86% of U.S. adults would be less likely to avoid or delay CRC screening if noninvasive options, such as blood tests, were offered.¹¹ Additionally, 51% reported that extra support such as help navigating health systems and answering questions would help them stay on track.⁶

Early cancer detection saves lives, but anxiety remains a significant barrier, particularly among men. By addressing fears, educating about options, and guiding patients through the process, PAs can help ensure that worry does not stand in the way of life-saving care.

References & Resources

1. American Cancer Society. (2026). Cancer Facts & Figures 2026. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2026/2026-cancer-facts-and-figures.pdf
2. National Institutes of Health. Cancer Stat Facts: Cancer of Any Site. https://seer.cancer.gov/statfacts/html/all.html
3. Aflac. (2025). 2025 Wellness Matters Survey overview. https://www.aflac.com/docs/cancer-campaign-wellness-matters/aflac-wellness-matters-survey.pdf
4. Wang Y, Hunt K, Nazareth I, Freemantle N, Petersen I. (2013). Do men consult less than women? An analysis of routinely collected UK general practice data. BMJ Open, 3(8):e003320. https://doi:10.1136/bmjopen-2013-003320
5. Cleveland Clinic. (2022). Cleveland Clinic Survey Reveals Men’s Top Health Concerns as They Age. https://newsroom.clevelandclinic.org/2022/09/07/cleveland-clinic-survey-reveals-mens-top-health-concerns-as-they-age
6. Prevent Cancer Foundation. (2025). 2025 Early Detection Survey. https://preventcancer.org/education-outreach/2025-early-detection-survey/
7. Jain MA, Leslie SW and Sapra A. (2023). Prostate cancer screening. ncbi.nlm.nih.gov/books/NBK556081/
8. S. Preventative Services Task Force (2025). https://www.uspreventiveservicestaskforce.org/uspstf/topic_search_results?topic_status=P
9. American Cancer Society (2026). Survival Rates for Colorectal Cancer. https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/survival-rates.html
10. De Koning HJ, Van der Aalst CM, De Jong PA, et al. (2020). Reduced Lung-Cancer Mortality with Volume CT Screening in a Randomized Trial. N Engl J Med., 382(6):503-513. https://doi:10.1056/NEJMoa1911793
11. (2025). Closing the Gap: CRC Screening Insights. https://guardanthealth.com/wp-content/uploads/Guardant-Health_Closing-the-Gap_CRC-Screening-Insights-1.31.25.pdf