A look at health screenings

Men are less likely than women to get regular diagnostic screenings and tests, especially when they are younger. But as men age, these screenings become even more essential. "Screenings and tests are still one of the best ways to find potential problems before they become serious," says Dr. Paul Heinzelmann, a primary care physician at Harvard-affiliated Massachusetts General Hospital.

There are all kinds of screening tests available for an array of potential health problems. So which ones do you need? Most of them fall into two categories: tests that almost all men should get and ones men should consider.

Get these

Most doctors follow screening guidelines from the U.S. Preventive Services Task Force (USPSTF), an independent panel of experts that reviews the value of tests based on the latest scientific evidence. "There are certain ones that men should definitely have at some point," says Dr. Heinzelmann. Essentially everyone should be screened for the following conditions.

Colon cancer. The USPSTF recommends people ages 45 to 75 get screened for colon cancer. For people ages 76 to 85, the decision should be based on life expectancy, overall health, and results of past screenings. After age 85, routine screening is more likely to cause harm rather than benefit. There are several ways to screen for colon cancer:

• Colonoscopy is the gold standard for screening. A doctor eases a thin, flexible tube mounted with a tiny video camera into the rectum. He or she examines the entire colon looking for, and possibly removing, growths called polyps. If no polyps are found, you repeat the exam in 10 years. If precancerous polyps are removed, your doctor may suggest another colonoscopy in three to five years.
• Flexible sigmoidoscopy is similar to a colonoscopy, but the doctor examines only the bottom third of the colon, where most polyps develop. This option is repeated every five years. If precancerous polyps are found, you will need a colonoscopy.
• CT colonography uses a CT scan to view the entire colon. While this test can spot polyps, it takes a colonoscopy to remove them. This test is repeated every five years.
• Stool-based tests are a less-invasive option; if the result is positive, you'll need a colonoscopy. There are several kinds. A guaiac-based fecal occult blood test (gFOBT) and fecal immunochemical test (FIT) work similarly. You place stool samples on test cards, put them in a supplied container, and send to your doctor for analysis. These should be done yearly. A multitargeted stool DNA test — also known by its brand name, Cologuard — combines the FIT with a test that looks for altered DNA in a stool sample you send to a lab. It is given every one to three years.

Diabetes. While it's a good idea for all adults to have at least one blood sugar test, almost 75% of men in America are considered overweight or obese (a body mass index of 25 or higher). This puts them at higher risk for diabetes, and they should get screened for type 2 diabetes starting at age 35.

Other candidates are those with a blood pressure reading of 135/80 millimeters of mercury (mm Hg) or higher or who currently take blood pressure medication. To diagnose diabetes (and prediabetes), doctors most commonly order a blood glucose test after fasting, or a non-fasting hemoglobin A1c level that reflects the average blood glucose over the prior two to three months.

Hepatitis C. This virus causes an infection that can damage the liver. All adults up to age 79 should get a blood test for hepatitis C, especially those who use injected drugs or have done so in the past. "This is a one-time screening for people with normal liver function and no special risk factors," says Dr. Heinzelmann.

High blood pressure. Adults should have their blood pressure checked at least annually. Current guidelines define elevated blood pressure as having a systolic measurement (the first number in a reading) of 120 to 129 and a diastolic measurement (the second number) lower than 80. A reading of 130/80 mm Hg or higher is considered high blood pressure.

Dr. Heinzelmann says getting your blood pressure check at the doctor's office can offer an accurate baseline reading. "But you should also use a home blood pressure monitor to compare the numbers, as some people suffer from white-coat syndrome, a condition where a person gets high blood pressure when they are around doctors," he says.

If you have elevated or borderline high blood pressure, your doctor may suggest checking it again after four to six months.

HIV. The USPTF recommends at least a one-time blood test for HIV infection for all men up to age 65 and for men older than 65 who continue to have more than one sexual partner or who have entered a new relationship.

Consider these

Men should also consider the following screening tests if they are at increased risk for a specific condition. "Talk with your doctor about whether these apply to you," says Dr. Heinzelmann.

Abdominal aortic aneurysm (AAA). This is a swelling in the lower section of the body's main blood vessel. The condition can worsen over time and cause the aorta to burst. Men ages 65 to 75 who have ever smoked should get a one-time ultrasound. Most people won't have symptoms, but they can include a pulsating feeling near the navel and pain in the chest, lower back, or above the kidneys.

Hepatitis B. People who are more likely to have been infected with the hepatitis B virus should get screened with a blood test, since many who have the virus don't show symptoms until the liver becomes inflamed or they develop cirrhosis (liver scarring). High-risk people include those who are HIV-positive, have used injected drugs, share a household with someone with the virus, and men in same sex relationships.

Lung cancer. Adults ages 50 to 80 who have smoked the equivalent of a pack of cigarettes a day for 20 years and who currently smoke or have quit within the past 15 years should consider an annual lung low-dose CT scan.

Image: © porcorex/Getty Images