Health Screening for Men: Why and When You Should Go to the Doctor
If men are reluctant to see their physicians when they are sick, imagine how often they see them when they feel well. However, screenings can provide critical information to help prevent future medical problems. While there is considerable debate regarding the value of routine screening for men, most authorities agree that detecting certain diseases before symptoms develop can often decrease the risk of serious illness and even death. Here is a guide to the most commonly recommended screening examinations and tests for men.
There are four ways to screen for cancer, and more commonly, precancerous polyps, on the inside wall of the rectum and colon. According to the American Cancer Society (ACS), beginning at age 50, men should follow one of these preferred testing schedules:
Another option for men who are unwilling or unable to have the above tests is having the stool checked yearly for signs of cancer.
People should begin colorectal cancer screening earlier and/or undergo screening more often if they have any of the following colorectal cancer risk factors listed below:
During a routine exam, the doctor may do a digital rectal exam. The doctor inserts a gloved finger into the rectum to detect any prostate enlargement, nodularity, or asymmetry that may indicate cancer. The exam takes approximately 30-60 seconds.
While it has become a controversial issue, the prostate specific antigen (PSA) test can be used as a screening tool for prostate cancer. Organizations like the US Preventative Services Task Force (USPSTF) recommend against the PSA test, highlighting the potential harms, like having to undergo unnecessary surgery.
What should men do? The ACS stresses the need to make an informed decision about prostate cancer screening. Talk to your doctor about the risks and benefits of screening. If you decide to be screened, your doctor will do the PSA test with or without the digital rectal exam.
A skin exam can determine if you have any moles or other lesions on the skin that may either be cancerous or precancerous. During a skin exam, which takes five minutes and is painless, a primary care physician or dermatologist studies the skin from head-to-toe, including the scalp. Your doctor may choose to biopsy (take a sample for laboratory analysis) any suspicious lesions. Recommendations for timing and frequency of skin cancer screening have not been clearly established.
The United States Preventive Services Task Force does not recommend routine screening or self-exam of teens and adults for testicular cancer. However, the American Cancer Society notes that men aged 20-39 should have a physical exam every three years to screen for various cancers, including testicular cancer. Talk to your physician about screening and risk factors for testicular cancer.
Heart Disease Screening
Blood Pressure Screening
Early detection of high blood pressure is extremely important because the longer high blood pressure goes undetected and untreated, the higher your risk of a heart attack, stroke, heart failure, kidney damage, and blindness.
If you already have high blood pressure (140/90 mmHg or higher), have it checked according to your doctor's recommendations. If your blood pressure is considered high normal (above 120/80 mmHg), you should have it checked every year. If your blood pressure is normal (below 120/80 mmHg), screening every two years is usually sufficient.
Cholesterol screening involves a simple blood test to measure your total cholesterol, low density lipoprotein (LDL) cholesterol, and high density lipoprotein (HDL) cholesterol (your doctor may also check your level of triglycerides, another fatty substance in the blood). High levels of total and LDL cholesterol (the "bad" cholesterol), and low levels of HDL cholesterol significantly increase your risk of atherosclerosis, a condition that may lead to coronary heart disease, heart attack, stroke, and other serious vascular problems.
All men 35 years old and older should have their cholesterol checked. If you are 20 years old or older and have other risk factors for heart disease, you should also have your cholesterol checked.
The American Diabetes Association recommends screening for all adults aged 45 years or older every three years, or every year if you are at increased risk. You should also be screened if you are of any age, are overweight or obese, and have other risk factors for diabetes.
There are a few different blood tests that can be done to check for diabetes. All can be done at a regular office visit, but some require you to be fasting before you come in.
Infectious Disease Screening
The Centers for Disease Control and Prevention recommends that all people aged 13-64 years old get screened for HIV infection. If you are at high risk for having HIV, you should be screened every year.
At least once a year (preferably twice), a dentist should examine your teeth and gums and check your tongue, lips, and soft tissues in your mouth to determine if you have cavities or problems of the gums, tongue, and mouth. A full set of x-rays should also be taken periodically to pinpoint areas of special concern.
The American Optometry Society recommends an eye examination ever 2 years for adults 18-60 years old. Older adults should have yearly eye exams. Also if you wear contact lenses, take medicines that can affect the eye, have diabetes, have high blood pressure, or have a family history of eye disease, you should have your eyes checked more often. Talk to your doctor if you experience any changes in your vision.
Screening Is Vital for Life-long Good Health!
While some of these tests can be embarrassing or uncomfortable, it is important to endure them because they can help prevent common and serious diseases. Keep in mind that if heart disease, cancer, or other major illnesses run in your family, these screenings and examinations are even more important. Encourage the men in your life to be screened as suggested.
American Cancer Society
National Cancer Institute
Canadian Family Physician
Heart and Stroke Foundation of Canada
Colorectal cancer screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated May 24, 2012. Accessed May 30, 2012.
Diabetes mellitus type 2. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 10, 2012. Accessed May 30, 2012.
How did the USPSTF arrive at this recommendation? US Preventative Services Task Force website. Available at: http://www.uspreve.... Published May 2012. Accessed July 27, 2012.
Hypercholesterolemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 14, 2011. Accessed February 15, 2011.
Moyer VA. Screening for prostate cancer: U.S. Preventative Services Task Force recommendation statement. Ann Intern Med. 2012 May 21. [Epub ahead of print].
Optometric Clinical Practice Guideline; Comprehensive Eye and Vision Examination. Available at:http://www.aoa.org/documents/CPG-1.pdf. Updated April 28, 2005. accessed February 24, 2011
Prostate cancer screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated July 22, 2012. Accessed July 30, 2012.
Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings. Centers for Disease Control and Prevention. MMWR 2006; 55(RR14);1-17.
Screening for prostate cancer: current recommendation. US Preventative Services Task Force website. Available at: http://www.uspreve.... Published May 2012. Accessed July 27, 2012.
Seminoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 5, 2012. Accessed May 30, 2012.
Wolf A, Wender R, Etzioni R, et al. American Cancer Society guideline for the early detection of prostate cancer. CA: A Cancer Journal for Clinicians. 2010;60:70-98.
Last reviewed May 2012 by Brian Randall, MD