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Health screening - men - ages 40 to 64

You should visit your health care provider regularly, even if you feel healthy. The purpose of these visits is to:

  • Screen for medical issues
  • Assess your risk of future medical problems
  • Encourage a healthy lifestyle
  • Update vaccinations
  • Help you get to know your¬†provider in case of an illness

Alternative Names

Health maintenance visit - men - ages 40 - 64; Physical exam - men - ages 40 - 64; Yearly exam - men - ages 40 - 64; Checkup - men - ages 40 - 64; Men's health - ages 40 - 64; Preventive care - men - ages 40 - 64

Information

Even if you feel fine, you should still see your health care provider for regular checkups. These visits can help you avoid problems in the future. For example, the only way to find out if you have high blood pressure is to have it checked regularly. High blood sugar and high cholesterol levels also may not have any symptoms in the early stages. Simple blood tests can check for these conditions.

There are specific times when you should see your provider. Below are screening guidelines for men ages 40 - 64.

BLOOD PRESSURE SCREENING

  • Have your blood pressure checked every 2 years. If the top number (systolic number) is between 120 - 139 or the bottom number (diastolic number) is between 80 - 89 mm Hg then have it checked every year.
  • Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked. Or check your blood pressure using the automated machines at local grocery stores and pharmacies.
  • If the top number is greater than 140 or the bottom number is greater than 90, schedule an appointment with your provider.
  • If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to have your blood pressure checked more often.

Effects of age on blood pressure

CHOLESTEROL SCREENING AND HEART DISEASE PREVENTION

  • If you are over age 34, you should be checked every 5 years.
  • If you have high cholesterol levels, diabetes, heart disease, kidney problems, or certain other conditions, you may need to be checked more often.
  • Some men should consider taking aspirin to prevent heart attacks. Ask your provider before you start aspirin because aspirin can increase your risk for bleeding.

DIABETES SCREENING

  • If you are over age 45, you should be screened every 3 years.
  • If you are overweight, ask your provider if you should be screened at a younger age.

COLON CANCER SCREENING

If you are under age 50, you should be screened only if you have a strong family history of colon cancer or polyps, or if you have had inflammatory bowel disease or polyps.

If you are between ages 50 - 75, you should be screened for colorectal cancer. This may involve:

  • A stool test done every year
  • Flexible sigmoidoscopy every 5 - 10 years along with a stool guaiac test
  • Colonoscopy every 10 years

You may need a colonoscopy more often if you have risk factors for colon cancer, such as:

  • Ulcerative colitis
  • A personal or family history of colorectal cancer
  • A history of large colorectal adenomas

DENTAL EXAM

  • Go to the dentist every year for an exam and cleaning.

EYE EXAM

  • Have an eye exam every 1 - 3 years if you have vision problems or glaucoma risk.

IMMUNIZATIONS

  • You should get a flu shot every year.
  • Your doctor may recommend other vaccinations if you have certain medical conditions, such as diabetes.
  • You should have a tetanus-diphtheria booster vaccination every 10 years. If you have not received a tetanus-diphtheria and acellular pertussis (Tdap) vaccine as one of your tetanus-diphtheria vaccines, you should have it once.
  • You may get a shingles or herpes zoster vaccination once after age 60.

OSTEOPOROSIS SCREENING

  • If you are between ages 50 - 70 and have risk factors for osteoporosis , you should discuss screening with your provider.
  • Risk factors can include long-term steroid use, low body weight, smoking, heavy alcohol use, or a family history of osteoporosis.
Osteoporosis

PHYSICAL EXAM

  • You should have a preventive health visit every 2 years until age 50, and then once a year.
  • Routine diagnostic tests are not recommended.
  • Your height, weight, and body mass index (BMI) should be checked at every exam.

During your exam, your provider may ask you about:

  • Depression
  • Diet and exercise
  • Alcohol and tobacco use
  • Safety, such as use of seat belts and smoke detectors

PROSTATE CANCER SCREENING

  • Most men age 50 or older should discuss screening for prostate cancer with their provider. African American men and those with a family history of prostate cancer should discuss screening at age 45.
  • The potential benefits of PSA testing have not been shown to outweigh the harms of testing and treatment. If you choose to be tested, the PSA blood test is most often done every year.
  • Prostate examinations are no longer routinely done on men with no symptoms.
Indications

TESTICULAR EXAM

  • The U.S. Preventive Services Task Force (USPSTF) now recommends against performing testicular self-exams. Doing testicular self-exams has no benefit.

LUNG CANCER SCREENING

The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 55 - 80 years who:

  • Have a 30 pack-year smoking history AND
  • Currently smoke or have quit within the past 15 years

References

American Diabetes Association. Standards of medical care in diabetes -- 2014. Diabetes Care. 2014;37 Suppl 1:S14-S80.

Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 14.

Centers for Disease Control and Prevention. Recommended Immunization Schedule for Adults, United States, 2014. Available at http://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule.pdf. Accessed July 24, 2014.

Gaziano M, Ridker PM, Libby P. Primary and secondary prevention of coronary heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders; 2012:1010.

Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014 Feb 5;311(5):507-520.

Helfand M, Carson S. Screening for Lipid Disorders in Adults: Selective Update of 2001 US Preventive Services Task Force Review. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Jun.

Levin B, Lieberman DA, McFarland B, Smith RA, Brooks D, Andrews KS, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: A joint guideline from the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin. 2008;58:130-160.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Colorectal cancer screening. Version 2.2013. Available at http://www.nccn.org/professionals/physician_gls/pdf/colorectal_screening.pdf. Accessed July 24, 2014.

National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. Washington, DC: National Osteoporosis Foundation; 2013.

Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension: what are the right goals and purposes? JAMA. 2014 Feb 5;311(5):474-476.

Rex DK, Johnson DA, Anderson JC, Schoenfeld PS, Burke CA, Inadomi JM; American College of Gastroenterology. American College of Gastroenterology guidelines for colorectal cancer screening 2009 [corrected]. Am J Gastroenterol. 2009;104:739-750.

Screening for Prostate Cancer. U.S. Preventive Services Task Force web site. Available at http://www.uspreventiveservicestaskforce.org/prostatecancerscreening.htm. Accessed July 24, 2014.

Smith RA, Cokkinides V, Brooks D, Saslow D, Brawley OW. Cancer screening in the United States, 2010. A review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin. 2010; 60(2):99-119.

Stone NJ, Robinson J, Lichtenstein AH, Bairey Merz N,  Blum CB, et al. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. Circulation. 2014 Jun 24;129(25 Suppl 2):S1-S45.

U.S. Preventive Services Task Force. Screening for osteoporosis: recommendation statement. Am Fam Physician. 2011;83:1197-1200.

Whitlock EP, Lin J, Liles E, Beil T, Fu R, O'Connor E, Thompson RN, Cardenas T. Screening for Colorectal Cancer: An Updated Systematic Review [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Oct.
http://www.ncbi.nlm.nih.gov/books/NBK35179/. Accessed July, 24, 2014.

Updated: 8/8/2014

Deborah Greenberg, MD, Associate Professor of Medicine, Division of General Internal Medicine, University of Washington, Seattle, WA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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