Health Screening for Men: Why and When You Should Go to the Doctor
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Health Screening for Men: Why and When You Should Go to the Doctor

How many men do you know who get an annual physical exam? Unfortunately, probably not many. Here's how physicals can help keep men healthy.

Many men tend to ignore symptoms, even potentially serious ones. A survey conducted by Men's Health magazine and CNN found that one-third of men would not go to the doctor, even if they were experiencing major health problems such as severe chest pains or shortness of breath—two indicators of potential heart disease.

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's a guide to the most commonly recommended screening examinations and tests for men.

Cancer Screening

Colorectal (Colon) Cancer
There are three 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 three testing schedules:

  1. Yearly fecal occult blood test (FOBT) or fecal immunochemical test (FIT) plus flexible sigmoidoscopy every five years.
  2. Double-contrast barium enema every five years.
  3. Colonoscopy every 10 years.

According to the ACS, a newer approach, the so called “virtual colonoscopy,” using a CT-scan, has not yet been fully validated.

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:

  • Personal history of colorectal cancer or adenomatous polyps
  • Strong family history of colorectal cancer or polyps
  • Family history of a hereditary colorectal cancer syndrome
  • Personal history of Crohn’s disease or ulcerative colitis

Prostate Cancer
Physicians generally use two tests to screen for prostate cancer:

  • Digital Rectal Exam (DRE)—The physician 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.
  • Prostate-Specific Antigen (PSA) Test—A blood test that measures the level of prostate specific antigen in your blood. While authorities disagree about the precise recommendations for having a PSA test, the ACS recommends that men with a family history of prostate cancer begin annual screenings at age 40. Men with no family history should begin annual screenings at age 50. If you're not sure when you should have the exam, ask your physician.

Skin Cancer
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 physician 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. Having your skin checked every three to five years starting at age 20 is probably reasonable. Beginning at age 40, screening is recommended more frequently.

Testicular Cancer
Since this is a relatively rare cancer, the frequency of screening examinations has not been clearly established, but it certainly should be done when visiting your physician for other preventive care. The National Cancer Institute additionally recommends testicular self-examinations beginning in adolescence. Ask your physician for a brochure that shows you how to perform a self-examination, and be sure to mention if testicular cancer runs in your family.

Heart Disease Screening

Blood Pressure Screening
One in four adults has high blood pressure and many don't even know they have it. 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 to three years is usually sufficient.

Cholesterol Screening
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.

Dental Screening

Dental Exam
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.

Vision Screening

Eye Exam
If you don't wear corrective lenses and you are under age 50, an eye exam every three to five years is usually sufficient. However, if you wear corrective lenses or are over 50, you should have your eyes examined every two years. Men with diabetes, high blood pressure, or a family history of vision problems should be examined at least once a year. An optometrist or ophthalmologist will check your eyes for glaucoma, deterioration of the retina, and cataracts. Talk to your doctor if you experience any changes in your vision.

Miscellaneous Tests

Your physician may recommend other screening tests depending on your medical history and risk factors. These include the following:

  • A urine and/or blood test for glucose, particularly if you have a family history of diabetes.
  • A blood test for HIV if you are sexually active with multiple partners or have other risk factors for HIV infection.

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.

RESOURCES:

American Heart Association
http://www.americanheart.org

National Cancer Institute
http://www.cancer.gov

CANADIAN RESOURCES:

Canadian Family Physician
http://www.cfpc.ca/cfp/

Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca

References:

Editors of Men's Health Magazine. The Complete Book of Men's Health: The Definitive, Illustrated Guide to Healthy Living, Exercise, and Sex. Rodale Press; 1998.



Last reviewed February 2008 by Jill D. Landis, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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