Health screening for men: why and when you should go to the doctor

Cancer screening

Colorectal cancer
There are three ways to screen for cancer, and more commonly, precancerous polyps, on the inside wall of the rectum and colon.

• Fecal occult blood testing (FOBT) - Testing of a stool sample for the presence of blood, which may indicate the presence of a polyp or a cancer.
• Sigmoidoscopy - A flexible tube with a light and a camera attached is inserted into the rectum to examine the lining of the rectum and part of the colon.
• Colonoscopy -A more involved procedure that uses a longer version of the sigmoidoscope to directly examine the entire colon.

Which test your physician performs depends on your risk for colorectal cancer. For men at average risk, FOBT is generally performed about every other year starting at age 40. If no blood is detected, a sigmoidoscopy (and possibly barium enema) is recommended every three to five years beginning at age 50. Men with a history of polyps or a family history of colon cancer are usually advised to have a colonoscopy every five years.

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 American Cancer Society 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:

• 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.