Men's screening tests: What, why and how often ?

By Mayo Clinic staff

You're not alone. Many men avoid going to the doctor. Maybe you're not comfortable talking about your health concerns, or maybe you feel OK and simply don't see any apparent reason to see your doctor.

If you're a man, it's important for you to make preventive visits to your doctor, says Philip Hagen, M.D., a specialist in preventive medicine at Mayo Clinic, Rochester, Minn. "You need to get the appropriate screening done. Each visit gives you an opportunity to talk with your doctor about your health behaviors and about life in general. It's important for you to establish a working relationship with a doctor in the event something is found."

You may want to avoid bad news. But, says Dr. Hagen, "The good news is that for the majority of diseases we screen for, if we detect the disease early, it will never be a problem."

The following recommendations are general guidelines for screening procedures for healthy men. Your doctor may recommend a different screening schedule based on a variety of factors, particularly your health history, age and family medical history.

Body measurement  

 

What is it?
Measurements of your height, weight and waist measurement and your body mass index.

Why?
To determine whether you're overweight or obese and to find out from your doctor whether your weight is a threat to your health. People who are overweight are more likely to have type 2 diabetes (formerly called adult-onset or noninsulin-dependent diabetes), high blood pressure and risk factors for other diseases.

How often?
At each visit for preventive care. The frequency varies with your age and any medical conditions you have. The American Heart Association recommends these measurements every 2 years after age 20.

Blood pressure  

 

What is it?
An inflatable cuff, wrapped around your upper arm, measures the amount of pressure your heart generates when pumping blood out through your arteries (systolic pressure) and measures the amount of pressure in your arteries when your heart is at rest between beats (diastolic pressure).

Why?
For early detection of high blood pressure (hypertension). Blood pressure is determined by the amount of blood your heart pumps and the resistance to blood flow in your arteries. Narrowed arteries limit your blood flow. In general, the more blood your heart pumps and the narrower your arteries, the harder your heart must work to pump the same amount of blood. The longer high blood pressure goes undetected and untreated, the higher your risk of heart attack, stroke, heart failure and kidney damage.

How often?
At least every 2 years.

 

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Cholesterol test  

 

What is it?
A simple blood test that measures total cholesterol, low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol), high-density lipoprotein (HDL) cholesterol (the "good" cholesterol) and triglycerides.

Cholesterol is a form of fat carried in your blood by lipoproteins. LDL deposits cholesterol on your artery walls, and HDL carries cholesterol away from your arteries and to your liver for disposal. Problems occur when your LDL deposits too much cholesterol on your artery walls or when your HDL doesn't take enough away. This can lead to a buildup of cholesterol-containing fatty deposits (plaques) in your arteries (atherosclerosis).

Why?
To evaluate the level of cholesterol in your blood. Heart disease is the No. 1 killer among men in the United States. Undesirable levels of cholesterol raise your risk of heart attack and stroke.

How often?
If you're 20 or older, have your cholesterol measured every 5 years. Your doctor may recommend more frequent measurements if your levels are abnormal.

What do the numbers mean?
Results from a blood fat test are listed as a set of numbers in milligrams per deciliter (mg/dL) indicating total cholesterol, low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol), high-density (HDL) cholesterol (the "good" cholesterol) and triglyceride levels. The National Cholesterol Education Program, a branch of the National Institutes of Health, has developed a set of guidelines to help determine which numbers are acceptable and which ones carry increased risk. These numbers apply to most people. If you have medical conditions such as diabetes or heart disease, your doctor can determine what cholesterol levels are best for you by taking into account your other medical conditions, habits and family history.

 


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Colorectal cancer screening  

 

What is it?
Your doctor may recommend tests to examine your colon and rectum to detect colon polyps that may become cancerous or colon cancer before symptoms occur. The exams are:

  • Fecal occult blood test (FOBT). This test chemically checks your stool for hidden (occult) blood that can only be detected through chemical testing. The test may be done in your doctor's office or you may be given a kit to take the stool sample at home. You usually obtain a stool sample for testing and store it in a supplied container or use an applicator stick to smear it on a chemically treated card. You then return the container or card in person or by mail to a lab or your doctor's office for analysis. At the lab, a chemical is applied to the specimen. The chemical reacts with the stool sample and appears as a different color if it comes in contact with blood.
  • Flexible sigmoidoscopy. Your doctor examines the lower portion of your colon by inserting a thin, flexible tube called a sigmoidoscope into your rectum. This procedure usually takes about 15 minutes. Sigmoidoscopy may be done along with a colon X-ray.
  • Colon X-ray (double-contrast barium enema). Liquid barium, a solution that looks bright white on X-ray images, is put into your colon using a slender tube inserted into your rectum. The barium outlines the inner surface of your colon, allowing the X-ray to detect any irregularities. This test typically takes about 20 minutes and can cause abdominal cramping. It may be done in conjunction with flexible sigmoidoscopy.
  • Colonoscopy. Your doctor examines the entire length of your colon using a thin, flexible colonoscope inserted into your rectum. The procedure is similar to a flexible sigmoidoscopy, although the instrument is longer so that your doctor can view your entire colon. This procedure can be somewhat uncomfortable, so you may be given intravenous medication to ease the discomfort (conscious sedation).


 

Why?
To detect cancer and growths (polyps) on the inside wall of your colon that may become cancerous.

How often?
Not everyone needs to be tested for precancerous polyps and colorectal cancer. Your need for screening depends on your level of risk. Three major factors place you at a higher level of risk of colorectal cancer:

  • Age 50 or older
  • Family or personal history of colorectal cancer or adenomatous polyps
  • Personal history of inflammatory bowel disease

If you're 50 or older and at average risk, the American Cancer Society recommends that you follow one of these five recommendations:

  • Yearly fecal occult blood test (FOBT)
  • Flexible sigmoidoscopy every 5 years
  • Yearly FOBT plus flexible sigmoidoscopy every 5 years
  • Double-contrast barium enema every 5 years
  • Colonoscopy every 10 years

If you're at higher risk, the American Cancer Society suggests talking with your doctor about earlier or more frequent screening.

 


 
 

Prostate cancer screening test  

 

What is it?
During the digital rectal exam (DRE), your doctor inserts a lubricated, gloved finger into your rectum, feels the prostate gland, and checks for any lumps or firmness in the prostate. The prostate-specific antigen (PSA) test is a blood test that measures the amount of a protein secreted by the prostate gland. The two tests are complementary, but there remains some controversy about the use of the PSA test.

Why?
DRE can detect prostate enlargement or prostate cancer. Don't be alarmed if your doctor tells you that your prostate gland is enlarged. More than half the men older than age 50 have an enlarged prostate caused by a noncancerous condition called benign prostatic hyperplasia (BPH).

With the PSA test, high levels of PSA may indicate prostate cancer. However, levels can be elevated by BPH or other noncancerous conditions as well.

How often?
The American Cancer Society suggests that you consider a yearly digital rectal exam and PSA test if you are 50 years of age or older. Consider screening at an earlier age if you are black or have a family history of prostate cancer.


 

Testicular examination  

 

What is it?
An examination of your testicles for masses or any change in size, shape or consistency of the testes.

Why?
To detect testicular cancer, the most common malignancy in American men between the ages of 15 and 35.

How often?
Your doctor should check your testicles whenever you have a physical exam. Men of all ages, starting in the midteenage years, should examine their testicles monthly.


 

Sexually transmitted disease screening tests  

 

What are they?
Screening tests to detect infections spread by sexual contact (sexually transmitted diseases or STDs) such as the human immunodeficiency virus (HIV), gonorrhea, genital herpes and chlamydia.

Why?
Many of these diseases have serious, sometimes fatal, complications.

How often?
Sexually active teens and young adults are at highest risk, but STDs can affect all age groups. Your doctor can determine whether you need STD screening tests based on your personal risk factors. Those who are at increased risk of infection include:

  • People who have had multiple sex partners, especially those who have exchanged sex for money or drugs
  • Males who have sex with males
  • Injection drug users and their sex partners

 


 

Dental checkup  

 

What is it?
Your dentist examines your teeth and gums with a probe and small mirror. He or she usually checks your tongue, lips and soft tissues.

Why?
To detect tooth decay and oral cancer, check your bite and determine if you have problems such as grinding your teeth or problems with your jaw joint.

How often?
The American Dental Association recommends that you have regular dental check-ups.

 

Eye examination  

 

What is it?
You read eye charts and have your pupils dilated with eyedrops. The ophthalmologist or optometrist checks your eye movement, peripheral vision, color vision and the sharpness (acuity) of your eyesight. He or she also views the inside of your eye using an instrument called an ophthalmoscope and, using a painless procedure called tonometry, measure the pressure inside your eyeball.

Why?
To determine whether you need glasses or contacts and to identify new vision problems. Common vision problems include:

  • Glaucoma. Increased pressure in your eye, which can lead to vision loss
  • Macular degeneration. Deterioration of retinal cells, which gradually decreases vision
  • Cataracts. Clouding of the clear lens of your eye, which blurs vision

How often?
The American Academy of Ophthalmology recommends screening once between the ages of 20 and 39, every 2 to 4 years between the ages of 40 and 64, and every one to two years after age 65. If you wear corrective lenses, talk with your doctor about how frequently you should have an eye exam.


 

Hearing test  

 

What is it?
Your doctor checks your speech and sound recognition at various volume levels.

Why?
To check for hearing loss.

How often?
The American Speech-Language-Hearing Association recommends screening at least every decade through age 50 and every 3 years after age 50. Ask your doctor how often you need your hearing checked.
 

Other screening tests  

 

These tests may or may not be part of routine medical exams. Your doctor may recommend them based on your signs and symptoms, risk factors, age and general health:

Electrocardiogram (ECG)
For this test, a technician places electrodes on your chest, arms and legs to pick up and record electrical impulses from your heart. An ECG can detect abnormalities such as heart damage after a heart attack, an irregular heart rhythm or an enlarged heart. In certain instances your doctor may recommend it as part of a health exam for instance, if you're at increased risk of heart disease or have a medical condition such as high blood pressure.

 


 

Chest X-ray
During a chest X-ray, your body is placed between an X-ray camera and a piece of X-ray film. Your doctor will probably request a forward view and a side view. Chest X-rays reveal the size and shape of your heart and the condition of your lungs, which can help your doctor detect heart or lung disease. Your doctor may recommend it as part of a health exam if you are short of breath, have a cough or chest pain, or if your doctor needs to see the size of your heart.

 


 

Blood chemistry test
This test measures substances such as sodium, potassium, calcium, phosphorus and blood sugar, as well as liver enzymes, bilirubin and creatinine. A blood chemistry test can provide information about how well organs such as your liver and kidneys are working. It can also detect diabetes.

Complete blood count (CBC) with differential
This test measures:

  • Hemoglobin amount determines oxygen-carrying capacity of your blood
  • Hematocrit percentage of blood volume made up of red blood cells
  • White blood cells number and type
  • Platelets number

A CBC can help detect the presence of many conditions, including anemia, infections and leukemia.

Fasting blood sugar test
This is a test that measures the level of sugar (glucose) in your blood after an 8-hour fast. High glucose levels can be an indication of diabetes. The American Diabetes Association recommends that if you're 45 or older that you have your blood glucose level checked every 3 years. If you're at risk of diabetes, your doctor may test you at a younger age or more frequently. Also get this test if you have signs and symptoms of diabetes, such as excessive thirst, frequent urination, unexplained weight loss, fatigue or slow-healing cuts or bruises.

 


 

Thyroid-stimulating hormone (TSH) test
This is a blood test for levels of TSH, a hormone made by the pituitary gland in your brain, which stimulates your thyroid to produce the hormone thyroxine. A TSH test can detect whether your thyroid produces too little thyroxine (hypothyroidism) or too much (hyperthyroidism).

Transferrin saturation test
This blood test measures the amount of iron bound to transferrin, an iron-carrying protein in your bloodstream. This test can detect hemochromatosis, also called iron-overload disease, a condition in which your body absorbs too much iron. Hemochromatosis is an under-recognized but treatable hereditary disease. When left untreated, it can lead to diabetes, arthritis, heart disease or liver disease. Doctors don't regularly test for hemochromatosis, but talk with your doctor if you have a brother, sister, parent, child or other close relative with hemochromatosis or if you have one of the following conditions that can be caused by hemochromatosis:

  • Joint disease
  • Severe and continuing fatigue
  • Heart disease
  • Elevated liver enzymes
  • Impotence
  • Diabetes

 


 

Urinalysis
This is a test to find out what's in your urine. Analyzing what's in your urine may reveal a medical problem. Sugar (glucose), for instance, suggests diabetes. White blood cells may indicate the presence of an infection. Red blood cells may signal a tumor or disorder of the kidneys, ureter or bladder. Elevated bilirubin may suggest liver disease.

Skin examination
To check for skin cancer, your doctor examines your skin from head to toe, looking for moles that are irregularly shaped, have varied colors, are asymmetric, are greater than the size of a pencil eraser, or have grown or changed since your last visit. The American Cancer Society recommends you have a skin exam every 3 years if you're between the ages of 20 and 40 and every year if you're age 40 or older.

 


 

Regular preventive exams help your doctor assess your overall health and risk factors for disease. By learning what's normal for you early on, you'll be able to detect any serious changes later. This information can help you decide what lifestyle changes you may need to make to prevent or reduce your risk of disease.

 

 

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