The Men's Medical Checklist
Seven tests that men shouldn't go without.
Reviewed By Michael Smith
Mike Keany (not his real name), a mechanic in Boston, is diligent about examining cars for his customers. Like many men, Keany was not as proactive about how his own system was running.
When Keany noticed a lump on his wrist, he ignored it until his wife and kids urged him to see his doctor. At first glance, his doctor was nearly certain the lump was benign. Keany wept with relief, still sitting on the examining table. A medical test confirmed the good news.
According to Keany's doctor, Martin Miner, MD, a professor in the department of ambulatory care and prevention at Harvard Medical School and a doctor in private practice, this is a typical story. "Men still perceive seeking healthcare as a link to their vulnerability, with which they're very uncomfortable," Miner says. It's hard enough, he points out, to convince guys to wear a helmet when inline skating, or a safety belt when driving, let alone to get their blood pressure checked.
This is unfortunate, says Miner, since men could benefit greatly from regular examinations. Conditions easily spotted by standard medical tests, such as high blood pressure and high cholesterol, which may lead to heart disease, can often be controlled with treatment. And for years, the American Cancer Society has been stressing that detecting cancer early is among the best ways to increase the chances of survival.
The following are the most commonly recommended tests for men.
Keep Your Senses Sharp
Eye exam: According to the American Optometric Association, the average adult man 60 years or younger should have an eye exam every two to three years. After age 60, you should have your eyes checked every year. Men with diabetes, high blood pressure, or a family history of vision problems should be examined at least once every one to two years. During eye exams, your doctor will check for glaucoma (increased pressure in the eye that leads to vision loss), macular degeneration (deterioration of the retina), and cataracts (clouding of the eye lens).
Dental exam: Although annual (or more frequent) dental examinations are often recommended, there are no firm guidelines on how often adults should get dental exams, according to the CDC. Taking special care to brush and floss daily is vital for maintaining the health of your teeth and gums, but how often a man visits his dentist is an individual decision. Some men will need to see the dentist more often than others. Men who smoke or chew tobacco as well as men with diabetes, dry mouth, or HIV infection may need more frequent dental visits because they are more at risk of developing problems.
Get Heart Smart
Blood pressure measurement: An inflatable cuff wrapped around your arm can detect high blood pressure, hopefully long before linked complications, such as heart attack and stroke, ever occur. Once a man reaches the age of 18, he should have his blood pressure checked. If blood pressure is normal -- less than 140/90 -- he should have it rechecked in one to two years, according to the National High Blood Pressure Education program. However, if blood pressure if found to be high, it should be rechecked in one to two months -- or the man may be started on treatment within a week if his blood pressure does not come down.
Cholesterol test: A cholesterol blood test, including total cholesterol, LDL "bad" cholesterol, and HDL "good" cholesterol, can help to evaluate your risk of heart disease. Beginning at age 20, you should be tested every five years -- assuming that your results are within desirable ranges -- according to the National Cholesterol Education Program. If your cholesterol level is above these ranges or you have a family history of heart disease, your doctor may recommend more frequent testing.
Hit Below the Belt
Colon exam: Doctors use a variety of tests to detect growth (polyps) or cancerous lesions inside the colon. Screening typically begins at age 50 but may begin earlier if there is a family history of colon cancer. The American Cancer Society recommends that men have an annual stool test to look for blood -- a sign of colon cancer. In addition, they say that men should have a test called a flexible sigmoidoscopy every five years -- which involves a small tube and camera inserted into the rectum to look at the first half of the colon. This test is often combined with a colon X-ray. Another option is to have a colonoscopy, which also involves a small tube inserted into the colon through the rectum. However, the colonoscopy looks at the entire length of the colon and needs to be done only every 10 years, says the ACS.
Prostate exam: There is much disagreement among different organizations about the benefits of testing for early prostate cancer. This stems from the fact that studies have not been able to conclusively prove -- in the minds of some experts -- that finding prostate cancer early can help save a man's life. For instance, the American College of Preventive Medicine recommends against routine screening with either the digital rectal exam (DRE) -- where the doctor exams the prostate through a rectal exam -- or the PSA (prostate specific antigen) blood test. The ACPM says that men should be armed with information about prostate cancer testing and make an individual decision with the help of their doctor. However, the American Cancer Society says that men age 50 or older with a life expectancy of greater than 10 years should be offered both the PSA blood test and the rectal exam. If you're at high risk for prostate cancer -- black men and men with a family history of prostate cancer -- it's a good idea to begin screening at age 45, they say.
Testicular exam: Testicular cancer, the most common malignancy among American men between the ages of 15 and 35, is usually curable, especially when detected early. Doctors agree that the testicular exam to look for cancer should be part of every physical examination by a doctor. However, not all doctors agree on the issue of monthly testicular self-exams to look for unusual changes or growths. The American Cancer Society feels that this decision should be an individual one between a man and his doctor, so talk to your doctor about the benefits of this exam -- and how to perform it if the two of you decide it's a good idea.
Originally published December 1999.
Medically updated April 4, 2003.
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Last Editorial Review: 1/30/2005 10:43:00 PM