All right, guys, let’s be honest. Where does scheduling an annual physical exam rank in its level of importance? If you’re under 40, probably somewhere between “cleaning the garage” and “not at all,” right?
Not too long ago, my wife was having a follow-up visit with her new internist after recovering from surgery to remove a liver abscess. At one point during the conversation, her physician turned to me and asked my age. “Forty-something,” I replied. “And when was the last time you had a physical?” he asked.
I froze—it had been a very long time. He looked up at the ceiling and then looked me straight in the eye. With a kind smile, he said, “Son, at your age, you should have a physical every year.” At your age. I wasn’t that old, I assured myself, yet those words were forever seared in my brain.
At your age!
Well, he convinced me. And yes, I have had an annual physical exam ever since, along with other tests he has recommended from time to time. The exams have uncovered some minor issues and have provided me with peace of mind.
For both men and women, the goal of preventive health screenings is to find problems early, before they become big problems. Knowing which tests are recommended for your age is especially important, as each test is recommended, based on prevalence and treatability in each age group. “I encourage my patients to get these tests at the recommended times so that they not only live long, but live well,” says Dr. Cheryl Rucker-Whitaker, assistant professor of preventive medicine at Rush University Medical Center. “The goal is to live a healthy, independent life into old age.”
Anyone who knows someone who has died in their 30s, 40s or 50s knows full well that they are best served by taking care of themselves. The following guide, which is based on the U.S. Preventive Services Task Force, outlines some of the recommended screening tests for men in a range of age groups. The list is by no means exhaustive, and screening needs often vary, based on a man’s family history, health habits and medical history.
20s – 30s
Regular checkups. During a regular checkup, according to Dr. Scott Palmer, doctor of internal medicine at Rush University Medical Center, a doctor will check height, weight and blood pressure and listen to the heart, lungs and the carotid arteries to check for abnormalities such as heart murmurs, breathing problems and early vascular issues. A good doctor should also scan your skin for skin cancer, check your mouth, ears, and lymph nodes, and feel your abdomen for any abnormalities. Frequency: Every two years for adults under the age of 40. After age 40, annually.
Cholesterol testing. Cholesterol is different from many tests in that it is not used to diagnose or monitor a disease but instead used to estimate the risk of developing a disease—specifically heart disease. Because high blood cholesterol has been associated with gradual blockage of the arteries (atherosclerosis), heart disease and an increased risk of death from heart attacks, cholesterol testing is considered a routine part of preventive healthcare. Frequency: Starting at the age of 35, at least once every five years. After age 40, annually.
Testicular screening. Doctors recommend regular testicular exams for males aged 15 to 40 to detect testicular cancer in its early stages. Testicular cancer is one of the most common cancers in men younger than age 35, and many testicular cancers are first discovered by men themselves. Frequency: For men between ages 15 and 40, monthly testicular self-exams are recommended.
STD testing. Testing for sexually transmitted diseases is important for men 25 and younger who are sexually active, according to the U.S. Preventive Services Task Force. A doctor will perform a DNA probe to check for gonorrhea and chlamydia and run blood tests to screen for syphilis, herpes, hepatitis B and C and HIV. Frequency: Annually, or every three to six months if you have a new sexual partner. Men in monogamous relationships should discuss their need for testing with their doctors.
BMI (Body Mass Index). Men should strive to maintain their ideal body weight to manage their risk for diabetes, high blood pressure, cardiovascular disease and cancer later in life. Calculate your Body Mass Index, a measure of body fat based on height and weight, by visiting The National Heart, Lung and Blood Institute’s website at nhlbisupport.com/bmi and using its BMI calculator tool. Frequency: Regularly
Blood pressure screening. The American Heart Association estimates that nearly one in three Americans has high blood pressure and doesn’t know it. Uncontrolled high blood pressure can lead to stroke, heart attacks and kidney failure, according to Palmer. Luckily, a simple screening can be performed at any doctor’s office. Frequency: Every two years, or more frequently, depending on family history. If your blood pressure is higher than 135/85, get tested annually.
Prostate exam. Prostate exams do not require much, other than a visit to the family physician or a urologist. The exam takes place in the doctor’s office and screens for prostate cancer with a blood test called a PSA. Frequency: After age 40, annually. Assuming there are no extenuating circumstances, some medical associations say the first prostate exam can wait till age 45.
Lipid profile and fasting blood-glucose test. A lipid profile is a simple blood test that screens for high cholesterol, which can increase a man’s risk for heart disease, stroke and, interestingly, gallbladder disease. Ideally, the test is done after fasting for six to eight hours. Likewise, a blood-glucose test measures blood glucose levels after fasting and can determine a patient’s risk for developing diabetes. A more definitive screen for diabetes is a glycohemoglobin blood test. Frequency: Lipid profile, annually, starting at age 40 to 45. If you smoke, have diabetes or a family history of heart disease, start having cholesterol checked at age 20. Blood-glucose test frequency varies depending on a patient’s blood pressure, cholesterol and family history.
Eye exam. A complete eye exam should be done, starting at age 40, to catch vision changes and to address eye-health problems. An ophthalmologist will check the pressure in the eye; elevated pressure is a sign of glaucoma (damage to the optic nerve that can result in blindness), which is usually highly treatable if caught early. An eye exam can also screen for the earliest changes of previously undiagnosed diabetes. Frequency: Every two years from age 40 to 65, assuming vision is fine. After 65, annually.
Heart disease testing. Several tests diagnose possible heart disease including cardiac stress tests and echocardiograms. The choice of which (and how many) tests to perform depends on variables such as a patient’s risk factors, history of heart problems and current symptoms, as well as the doctor’s interpretation of these factors. Frequency: Depends on age, family history and initial cholesterol levels.
Colonoscopy. During this procedure, a doctor uses a colonoscope (an instrument with a tiny video camera) to explore the inside of the large intestine for issues such as inflamed tissue, abnormal growths and ulcers. Ask your internist for a referral to a gastroenterologist, who performs colonoscopies. Frequency: Once at age 50 and then based on your doctor’s recommendation; those with an inflammatory bowel disease or a family history of colon cancer may be screened earlier.
Abdominal Aortic Aneurysm. According to the U.S. Preventive Services Task Force, if you are between the ages of 65 and 75 and have ever smoked (100 or more cigarettes during your lifetime), you need to be screened once for abdominal aortic aneurysm, which is an abnormally large or swollen blood vessel in your abdomen.
For additional information, consult the U.S. Preventive Services Task Force of the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services: ahrq.gov/clinic/uspstfix.htm
For additional information on the list of recommended preventative medical screening tests, the AHRQ provides separate web pages for men and women: ahrq.gov/ppip/healthymen.htm; ahrq.gov/ppip/healthywom.htm
(Reprinted from Chicago Health: Top Doctors & Hospitals, November 2010)
Published in Chicago Health Winter 2010