Men’s health often gets less attention than women’s health, perhaps because men are 24 percent less likely than women to have seen a doctor within the past year.1 Just over half of U.S. men (57 percent) visit a doctor, nurse practitioner or physician assistant for routine care, compared with 74 percent of women.2 Regardless, men need certain preventive tests and screenings on a regular basis to ensure good health.
Prostate cancer: To screen or not to screen
Unique to men is screening for prostate cancer. Screening can detect cancers early and treatment may be more effective for early disease. Screening is done by digital rectal exam (DRE) or a blood test for prostate-specific antigen (PSA). In DRE, the clinician inserts a gloved, lubricated finger into the rectum to feel the prostate, estimate its size and feel for any abnormalities.
The PSA test measures the level of PSA in the blood. Prostate cancer can cause an elevated PSA level, but many factors, such as age and race, can also affect it.
The most recent evidence suggests that PSA testing does not lower the risk for death from prostate cancer. A 13-year follow-up report published in the Journal of the National Cancer Institute concluded that there is no evidence of benefit from PSA screening. The test can, in fact, cause harm because of false-positive tests and overdiagnosis.3 This finding extends the trial's 10-year results, which also showed no mortality benefit.
The Centers for Disease Control and Prevention and other federal agencies follow the prostate cancer screening guidelines set forth by the U.S. Preventive Services Task Force, which state that there is not enough evidence to recommend or discourage routine screening for prostate cancer using PSA or DRE.4
Other preventive screening tests
Men — as well as women — should consider a number of other routine screening tests to maintain optimal health:5
Body mass index* — Your body mass index, or BMI, is a measure of your body fat based on your height and weight. It is used to screen for obesity. Find your BMI.
Cholesterol — Once you turn 35 (or once you turn 20 if you have risk factors like diabetes, history of heart disease, tobacco use, high blood pressure, or BMI of 30 or higher), have your cholesterol checked every five years. High blood cholesterol is one of the major risk factors for heart disease.
Blood pressure — Have your blood pressure checked every two years. High blood pressure increases your chance of getting heart or kidney disease and for having a stroke. If you have high blood pressure, you may need medication to control it.
Cardiovascular disease* — Beginning at age 45 and through age 79, ask your doctor if you should take aspirin every day to help lower your risk of a heart attack. How much aspirin you should take depends on your age, your health and your lifestyle.
Colorectal cancer* — Starting at age 50 and through age 75, get tested for colorectal cancer. You and your doctor can decide which test is best. How often you'll have the test depends on which test you choose. If you have a family history of colorectal cancer, you may need to be tested before you turn 50.
Other cancers — Ask your doctor if you should be tested for prostate, lung, oral, skin or other cancers.
Sexually transmitted diseases — Talk to your doctor to learn whether you should be tested for gonorrhea, syphilis, chlamydia or other sexually transmitted diseases.
HIV — Your doctor may recommend screening for HIV if you:
Have sex with men.
Had unprotected sex with multiple partners.
Have used injected drugs.
Pay for sex or have sex partners who do.
Have past or current sex partners who are infected with HIV.
Are being treated for sexually transmitted diseases.
Had a blood transfusion between 1978 and 1985.
Depression* — If you have felt "down" or hopeless during the past two weeks or have had little interest in doing things you usually enjoy, talk to your doctor about depression. Depression is a treatable illness.
Abdominal aortic aneurysm — If you are 65 to 75 years old and have smoked 100 or more cigarettes in your lifetime, ask your doctor to screen you for an abdominal aortic aneurysm. This is an abnormally large or swollen blood vessel in your stomach that can burst without warning.
Diabetes* — If your sustained blood pressure is 135/80 or higher, ask your doctor to test you for diabetes. Diabetes, or high blood sugar, can cause problems with your heart, eyes, feet, kidneys, nerves and other body parts.
Tobacco use — If you smoke or use tobacco, talk to your doctor about quitting. Get tips online on how to quit or call the National Quitline at 1-800-QUITNOW.
Alcohol use — Moderate drinking levels for men are no more than 14 standard drinks on average per week and no more than four drinks on any occasion. Men older than 65 should drink half of what is recommended for younger men (seven drinks on average per week and no more than three on any occasion).
Remember, preventive medical tests benefit you AND your family and loved ones.
*Denotes HealthTeamworks guideline
1. Agency for Healthcare Research and Quality. Healthcare Cost & Utilization Project and Medical Expenditure Panel Survey data.
2. Agency for Healthcare Research and Quality. Men Shy Away from Routine Medical Appointments. AHRQ News and Numbers, June 165, 2010. www.ahrq.gov/news/nn/nn061610.htm
3. Andriole GL, et al. Prostate cancer screening in the randomized prostate, lung, colorectal, and ovarian cancer screening trial: Mortality results after 13 years of follow-up. http://jnci.oxfordjournals.org/content/early/2012/01/06/jnci.djr500.abstract JNCI J Natl Cancer Inst (2012)doi: 10.1093/jnci/djr500First published online: Jan. 6, 2012
4. Chou R, Croswell JM, Dana T, et al. Screening for Prostate Cancer: A review of the evidence for the U.S. Preventive Services Task Force. www.uspreventiveservicestaskforce.org/uspstf12/prostate/prostateart.htm. Oct. 2011.
5. U.S. Department of Health and Human Services. Agency for Healthcare Research and Quality. Get Preventive Medical Tests. www.ahrq.gov/healthymen/prevent.htm