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Your Health Blog

    Health Screenings Men Need - When & Why

    Michael Luy, MD, Internal Medicine, Deaconess Clinic Downtown 08/22/2017
    Health screenings help doctors and other providers detect conditions at earlier, more treatable stages.  Whether we’re screening for blood glucosecholesterol or PSA the goal of all screenings is to bring attention to a problem or a developing problem.
     
    Below I address various screenings that men need and at what ages, and share some additional details that can help men make informed decisions in partnership with their doctor.

    These are joint recommendations from the American Cancer Society, American Heart Association and American Diabetes Association.  I’ll break them out by decades of age.
     
    Age 20-29 years AND 30-39 years

    A man needs to have his BMI (body mass index) and blood pressure screened annually/at each routine healthcare visit.

    Cholesterol (lipid profile) should be checked every 5 years, or more often if abnormal.

    Blood glucose and colon cancer testing is only needed if the man is at an above average risk. If not, no additional testing is needed at this time.

    Most insurance companies will cover screening tests as recommended by your physician.
     
    Age 40-49 years

    A man needs to have his BMI (body mass index), and blood pressure screened annually/at each routine healthcare visit.

    Cholesterol (lipid profile) should be checked every 5 years, or more often if abnormal.

    Blood glucose should be checked every three years beginning at age 45; more often or earlier if indicated by doctor.

    Colon cancer testing is only needed if the man is at an above average risk. If not, no additional testing is needed at this time.

    Prostate cancer screening (for all African American men and also all men with close family members with prostate cancer) should be discussed with a health care professional early in this decade.  More prostate cancer screening information is below.

    Most insurance companies will cover screening tests as recommended by your physician.
     
    At 50-64 years


    A man needs to have his BMI (body mass index), and blood pressure screened annually/at each routine healthcare visit.

    Cholesterol (lipid profile) should be checked every 5 years; more often if abnormal or under treatment for high cholesterol, or if recommended by your doctor.

    Blood glucose should be checked every three years; more often or earlier if indicated by doctor.

    Colon cancer testing should begin at age 50; maybe earlier if the man has significant risk factors or family history. (Some new guidelines recently issued by the American Cancer Society recommend screening at age 45.) Talk with your doctor about which tests are best for you (fecal occult, colonoscopy, etc.) and how frequently the tests should be done.

    Prostate cancer testing: Talk with your doctor about the potential benefits and limitations of testing to decide what tests are right for you, and when they should be performed.  (More information below).

    Most insurance companies will cover screening tests as recommended by your physician.
     
    At 65 and older
     
    The guidelines are the same as for ages 50-64. However, a great thing is that all these screening services are now covered by Medicare!
     
    More specifics about prostate cancer screening

    Recommendations for PSA (prostate specific antigen) and other screening tests can be confusing. All men over 40 are encouraged to talk to their doctor about prostate cancer screenings, so they can decide together what options are best for them.
     
    Here are my recommendations on who should be definitely be screened for PSA.
    • Men who have family history of prostate cancer (uncle, father, grandfather, brother)
    • Any man who is concerned about his prostate health and wants to monitor changes.
    • Men who have urinary symptoms such as slow stream, delay or interruption in starting stream, urgency and frequency, excessive nighttime urination, etc.
    • Men who at risk and likely to survive 10 years beyond the time of screening. (Meaning, if cancer is detected, the patient is likely to benefit from treatment options.)
    Screening for prostate cancer with PSA has potential benefits and harm. Due to the lack of definitive data on screening outcomes, it is particularly important that patients make informed decisions about undergoing testing. The US Preventive Services Task Force Guidelines, American College of Physicians, American Urologic Association and the American Cancer Society all stress the importance of informed decision making.
     
    Who should NOT be screened for PSA

    In the U.S. Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, the U.S. investigators report no life-extending benefit from combined screening with PSA testing and digital rectal examination during an average follow-up of 7 years.

    In the European Randomized Study of Screening for Prostate Cancer (ERSPC) trial, the European investigators report that PSA screening without digital rectal examination was associated with a 26% relative reduction in the death rate from prostate cancer at an average follow-up of 11 years. This means a reduction of about 9 men dying of prostate cancer per 10,000 men screened.

    THEREFORE, at the present time, data does not support PSA screening for prostate cancer in men whose 10 year survival is questionable.

    If you’d like an additional perspective on prostate cancer screening, my colleague Dr. Joseph Klink, urologic oncologist at Deaconess Clinic, shares his insights.

    Catching disease and health problems at their earliest stages nearly always leads to better outcomes.  Men can live their longest and best lives by being proactive about their health.  Talk to your doctor about what screenings are right for you.
     
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