15 Medical Tests Every Man Should Have
January 26, 2011
Medical screening tests are a great way to keep on top of your health. Think of them as basic maintenance, just like checking the oil and tire pressure to keep your car safe on the highway. To keep it simple, we've compiled a list of the most important medical tests every man should have—along with what age to start and how often to repeat. Here's to routine maintenance for your health.
Cholesterol is a type of fatty protein in your blood that can build up in your arteries, so knowing how much cholesterol is present is a good predictor of your risk for heart disease. There are two kinds of cholesterol: HDL, or high-density lipoproteins, and LDL, or low-density lipoproteins. Confusingly enough, HDL is "good" and protects against heart disease, while LDL is "bad" and poses a risk to your heart.
Your total cholesterol reading combines the measures of both and is used as an overall reading; 220 is the magic number that you want to stay beneath. In addition, the profile measures triglycerides, which are fats in the blood that can also block arteries; you want them below 150 milligrams per deciliter.
What Are the New Cholesterol Tests?
What it is: A blood test for cholesterol, measured in milligrams per deciliter of blood (mg/dl); usually measures triglycerides at the same time
When to start: Age 20
How often: Every five years. If testing reveals your levels are high, your doctor will recommend retesting every six months to one year. If you have risk factors for heart disease in your family, the regular cholesterol test may not be specific enough; ask your doctor for an additional test called the lipoprotein subfraction test. It's more sensitive and checks the size of the cholesterol particles as well as the amount.
2. Blood pressure check
It seems simple, but checking your blood pressure regularly is one of the most important things you can do to protect your present and future health. One in every five adults, totaling 50 million people, has elevated blood pressure, also known as hypertension. When your blood pressure readings are higher than the cutoff of 140/90, it puts stress on your heart, leaving you at risk for heart attack and stroke. Many experts believe 120/80 is a healthier target to shoot for.
What it is: A physical reading using an arm cuff
When to start: Any age; best to begin during childhood
How often: Once a year if readings are normal; your doctor will recommend every six months if readings are high or if you're taking medication to control hypertension.
To check your risk for diabetes, doctors check your tolerance for glucose absorption, which means how readily your body digests sugar.
What it is: A blood draw performed after drinking a sugary drink; a fasting glucose tolerance test requires you not to eat for nine hours prior to the test.
When to start: At age 45 if you have no risk factors or symptoms. If you're significantly overweight, have high blood pressure, or have other risk factors for diabetes, such as family history of the disease, it's a good idea to get tested younger. If your insurance doesn't cover it, free testing is available at most major chain drugstores.
How often: Every three years
4. Bone density test
The loss of bone strength, called osteoporosis, afflicts nearly 10 million people every year, according to the National Osteoporosis Foundation. Surveys show that men see osteoporosis as a "woman's disease," but this is a misconception. After age 50, 6 percent of all men will break a hip and 5 percent will have a vertebral fracture as a result of osteoporosis. As we age, minerals such as calcium begin to leach from bones, weakening them and leading to osteoporosis, which literally means "porous bone."
What it is: A specialized X-ray called a DXA (dual-energy X-ray) screens your spine, hips, and wrists as you lie on a table.
When to start: At age 65, everyone should have a DXA. But men who have risk factors for bone loss, such as being thin, taking corticosteroids, or having a history of fractures, should talk to their doctor about being screened now.
How often: Every five years
Recently, doctors have realized that vitamin D is a key nutrient that helps maintain strong bones and protect against cancer, infection, and other health conditions. For example, a study last year found that men with low levels of vitamin D had a higher incidence of heart attack. Most men have no idea if they're D-deficient or not, though a simple blood test can tell. If you live in a northern climate, work indoors, or don't drink a lot of milk, chances are your vitamin D level is low. If so, your doctor will recommend taking a vitamin D supplement.
What it is: A blood test, often done along with the cholesterol and lipid panel, to check the level of vitamin D in your blood. You want your reading to be between 30 and 80 nanograms per milliliter, though some experts argue that 50 nanograms should be the lowest level considered normal. Many experts recommend the 25(OH)D3 test as providing the more accurate measurement.
When to start: Age 40; sooner if you have signs or risk factors for osteoporosis. As we age, our bodies become less efficient at synthesizing vitamin D from the sun, so after the age of 40 it's more likely that you'll become D-deficient. Also, if you have any signs of low bone density, such as a fracture, your doctor will want to test your vitamin D along with your bone density.
How often: Although vitamin D testing isn't yet required or listed on the official schedule of recommended tests, more and more doctors are recommending it as an annual test after age 45.
6. Colonoscopy or sigmoidoscopy
Colorectal cancer, which is cancer of the lower part of the intestines, is curable in 90 percent of all cases—as long as it's caught early. And screening tests that look inside the colon, called colonoscopy and flexible sigmoidoscopy, are the secret to catching it early.
Unfortunately, this still isn't happening as often as it should. Currently, 39 percent of cases are already stage III or IV when discovered. This test is considered so lifesaving that news anchor Katie Couric allowed hers to be presented on live TV as an educational campaign to raise awareness after her husband died of colorectal cancer. Colorectal cancer is the third leading cause of death from cancer for men, after lung and prostate cancer, so it's important to take it seriously.
What it is: An examination of your colon using a tiny scope and camera, which are inserted through the rectum. A colonoscopy can see the whole colon, while a sigmoidoscopy can see only the sigmoid, or lower section of the colon.
When to start: Age 50 for those with no risk factors. If, however, you have a first-degree family member who's had colon cancer before the age of 50, begin colonoscopy screening when you're 10 years younger than the age at which your family member was diagnosed. If a family member was diagnosed at 45, for example, you should have your first screening at 35.
How often: Flexible sigmoidoscopies should be repeated every five years, and a colonoscopy should be repeated every 10 years. A computerized imaging technique called virtual colonoscopy is gaining popularity at some medical centers, but many doctors still consider it experimental and some insurers, including Medicare, don't cover it.
7. Fecal occult blood test (FOBT)
Although it sounds otherworldly, the word occult simply refers to the fact that this test checks for blood in the stool that's not visible to the eye. This is the least invasive screening tool available. A chemical solution is used to test a stool sample for the presence of blood, which can indicate intestinal conditions such as Crohn's disease and ulcerative colitis, or colorectal cancer.
Colorectal cancer still strikes more men than women—more than 50,000 men are diagnosed with the disease every year.
What it is: A stool sample test that looks for blood in the stool using a chemically treated pad that turns blue in the presence of blood. Three stool samples are collected on consecutive days, since cancer and other conditions may not bleed consistently.
When to start: At age 50; your doctor may suggest it earlier if there's cause for concern about intestinal conditions.
How often: Yearly after age 50
8. Skin cancer screening
Skin cancer, while less deadly than some, is the No. 1 cancer diagnosed among Americans. And men are at higher risk for skin cancer than women, something most men don't know. While most types of skin cancer are easily treated, one type, melanoma, can be deadly. Skin cancer is relatively easy to detect as long as you bring any suspicious areas to the attention of your doctor.
What it is: An examination of your skin, particularly moles, lesions, or other areas that are changing or growing.
When to start: Any age
How often: Experts recommend conducting a personal "mole check" once a month in the shower to look for unusual growths or changes to existing moles. If you notice anything suspicious, call your doctor. Many communities offer free skin cancer screenings, usually held at drug stores or clinics. They're often held in May, just as the summer season begins and people start to expose more skin.
9. Eye exam and vision screening
Whether you have problems seeing at a distance or close up, you need regular eye exams as you age to check the overall health of your eyes. The American Academy of Ophthalmology says that by the year 2020, 43 million Americans will have some type of degenerative eye disease, yet surveys show that more than a third of adults fail to get regular eye exams.
What it is: A vision screening tests how well you can see; an eye exam checks for glaucoma, macular degeneration, retinopathy, and other eye diseases. Make sure you're having both kinds of exams.
When to start: Age 18
How often: Every one to three years between the ages of 18 and 61, says the American Optometric Association; after that, as often as your doctor thinks is necessary depending on what's happening with your vision. If you have diabetes, you're at much higher risk for eye problems and should be checked more often.
10. Hearing test (audiogram)
Fourteen percent of adults between ages 45 and 64 have hearing loss, and by the age of 60 one in three adults is losing hearing. Men are at highest risk for all types of noise-induced hearing loss, the most common type. Yet many men go years before getting tested, primarily because hearing tests are voluntary. You and your doctor have to decide that you need a hearing test and request one.
If you notice problems following conversations, missed social cues, or an inability to distinguish people's speech from background noise, ask for a referral to an otolaryngologist to check the condition of your ears, and an audiologist to check your hearing.
What it is: A series of tests to assess different aspects of hearing. Tone tests are used to measure your overall hearing, while additional tests check inner- and middle-ear function and evaluate your ability to register speech.
When to start: When you or others notice problems
How often: Hearing tests are voluntary, but the American Speech-Language-Hearing Association recommends hearing tests every 10 years for adults up to the age of 50. After that, experts say, you should have a hearing test every three years.
11. Thyroid test
The thyroid, a small gland in your neck, regulates your body's metabolic rate. If your thyroid is overactive, a condition known as hypothyroidism, your metabolic rate is too high. Symptoms include insomnia, weight loss, and overactive pulse. If you're hypothyroid, it means your thyroid is underactive and your metabolism will be slow and sluggish. This usually leads to fatigue, constipation, and weight gain. While more women than men are hypothyroid, that doesn't mean men can't be—and in men, hypothyroidism can cause some upsetting side effects, such as erectile dysfunction, low sex drive, and ejaculation problems.
What it is: The most common test, the TSH test, is a blood test that measures the level of thyroid-stimulating hormone. The desired level is between 0.4 and 5.5. However, many experts believe testing thyroxine (a hormone made by the thyroid) directly with what's called the T4 test is a more accurate way to assess thyroid function.
When to start: Age 35
How often: Once a year, says the American Thyroid Association. Other doctors don't recommend a thyroid test for midlife adults unless you have symptoms of hypothyroidism or hyperthyroidism. After the age of 60, thyroid testing is usually conducted annually.
12. Screening for metabolic syndrome
Metabolic syndrome is a group of symptoms that put you at increased risk for both diabetes and heart disease. The screening involves checking for a list of issues and, if they're present, recommending additional tests. Doctors consider men to have metabolic syndrome if three of the following five risk factors are present:
Waist circumference greater than 40 inches
Low "good" cholesterol (below 40 mg/dL)
Elevated triglycerides (greater than 150 mg/dL)
Blood pressure higher than 130/85
Fasting glucose above 100 mg/dL
If three or more of these apply, ask your doctor for an additional screening test called the C-reactive protein (CRP), which many experts think is the best way to monitor heart health risks.
What it is: A blood test that measures an inflammatory marker for plaque buildup
When to start: Age 50
How often: Every three to five years, along with cholesterol and diabetes screening
13. Testicular cancer screening
Lance Armstrong brought testicular cancer to national attention, but many men still don't know the signs of this disease. With early detection, a man's chances of survival go up by a whopping 90 percent, so it pays to be vigilant. While testicular cancer is rare, it's the most common type of cancer in younger men, ages 15 to 34.
What it is: A self-exam or doctor's exam for tumors in the testicle. The doctor (or you) rolls each testicle slowly between thumb and forefinger, looking for any hardened areas or lumps and checking to make sure there haven't been changes in size.
When to start: All ages
How often: The Livestrong Foundation recommends that all men do a self-exam every month for testicular cancer. Sometimes a man's partner is the first to notice signs of testicular cancer. At the first sign of concern, call your doctor and ask for an examination. Your doctor may also recommend an ultrasound or a blood test for tumor markers that can indicate testicular cancer.
Not the favorite of most men, the digital rectal exam is a lifesaver because prostate cancer is one of the most common types of cancer, affecting one in six men. A second test, called the PSA test, is used to look for elevated levels of prostate-specific antigen. While the PSA test has come under fire for producing a high number of false positives, it's still the best first-line blood test for prostate cancer.
What it is: A digital rectal exam in which the doctor inserts a finger into the rectum to feel the prostate gland, and a blood test that measures the level of prostate-specific antigen.
When to start: Age 50, according to the American Cancer Society, unless you have symptoms such as difficulty with urination. In that case, see your doctor for a prostate cancer exam at age 45.
How often: Every year
15. Bladder cancer screening
Men, particularly Caucasian men and men who have a history of smoking, are at an elevated risk for bladder cancer. In the early stages, bladder cancer can be symptomless, and in these cases a test is the only way to detect it. There's a good reason to be vigilant about bladder cancer: If caught while still localized, it has a cure rate of 95 percent. While routine bladder cancer screening is not yet recommended, talk to your doctor if you're Caucasian and a smoker.
What it is: A urine test that looks for small amounts of blood in the urine not visible to the eye
When to start: Age 50, if you have a history of smoking
How often: When your doctor recommends it. Another test recently introduced checks the urine for a marker called NMP22; this test is expected to come into wider use in the next few years.
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