There are many recommendations for health screenings for people in various age groups, but one particular demographic that's not often discussed is older men. We've talked about the importance of regular screening for breast cancer for older women (through monthly breast self-exams and periodic mammograms), but what preventative health screenings should older men receive? We've identified five of the most recommended and important screenings to help older men be more proactive about their health.
Blood pressure, cholesterol, and heart disease prevention
While blood pressure and cholesterol screenings are actually different tests, we've grouped them together as a single recommended screening simply because it's easy to have these screenings all performed at the same time. According to the National Institutes of Health, U.S. National Library of Medicine, men over the age of 65 should have their blood pressure checked annually and their cholesterol checked every five years – if your levels are normal. An EKG (Electrocardiogram) may be included with this group of screenings and is recommended for adults over age 50 every three years.
If your levels are abnormal, or you have high cholesterol, diabetes, heart disease, kidney problems, or other related conditions, it may be necessary to have your blood pressure, cholesterol levels or both checked more frequently. Your healthcare provider will direct you if your current health status necessitates more frequent screenings.
According to the Mayo Clinic, "The majority of prostate cancers are found in men age 65 or older." The American Cancer Society recommends that discussions about prostate screening should begin between healthcare providers and men at the age of 50. Together, they can decide whether prostate screening is right for him. Should he move forward with testing, he will receive a PSA (prostate specific antigen) test, which is a blood test, with or without a DRE (digital rectal exam).
The frequency of prostate screenings moving forward is based on the man's PSA level. However, PSA testing is only recommended for men with a life expectancy of 10 to 15 years, and as the Mayo Clinic points out, some experts and health providers have concerns with the risks involved with PSA testing. Therefore, most health organizations leave this decision up to the individual and his healthcare provider.
Colorectal cancer screening
Colorectal cancer (CRC) is the third leading cause of cancer-related deaths among men in the United States, behind lung and prostate cancer. However, with proper screening and the removal of adenomatous polyps (precancerous polyps, or growths which can be removed before symptoms develop), most CRC is preventable. Yet, one-third of adults between the ages of 50 and 75 are not getting the recommended screenings.
There are a variety of imaging tests and laboratory tests which can be used to screen for colorectal cancer. A colonoscopy or sigmoidoscopy are the tests most frequently recommended by organizations such as the American Cancer Society, U.S. Preventive Services Task Force (USPSTF) and the American College of Gastroenterology (ACG), and most recommendations suggest that screenings should begin at the age of 50 and continue through the age of 75 for men (and women) with average risk. The general recommendations for those with average risk include a stool test annually, a flexible sigmoidoscopy every 5 - 10 years with a stool guaiac test or a colonoscopy every 10 years. Men with a family history of colorectal cancer or other risk factors may benefit from more frequent screenings. These men should discuss their risk factors with their healthcare providers to determine whether more frequent, aggressive screenings are advisable.
The National Diabetes Education Initiative (NDEI) highlights the diabetes screening guidelines recommended by the American Diabetes Association (ADA). These guidelines recommend screening for any adult who is overweight or obese (defined as a BMI - Body Mass Index - of 25 or higher or 23 or higher in Asian Americans) and has one or more diabetes risk factors.
Risk factors may include a first-degree relative with diabetes, physical inactivity, a history of cardiovascular disease, hypertension (high blood pressure), a high A1C (average blood glucose over a 2-3 month period) from a previous screening, risk factors related to race or ethnicity, or other conditions associated with insulin resistance, such as severe obesity or a condition called acanthosis nigricans. Testing should begin at age 45, particularly if the patient is overweight or obese, and if results are normal may be repeated every three years. A fasting plasma glucose (FPG) is typically the first screening method of choice. Results are typically confirmed with a second screening method on a different day, such as 2-hour postload plasma or hemoglobin A1C.
Dental, vision, and hearing exams
Dental, vision, and hearing exams are, of course, all distinct screening tests. While annual dental exams and cleanings and annual or bi-annual eye exams are considered pretty standard practice, it's easy for older men to become less diligent about following through with these screenings as they get older.
Older men should have dental exams (and cleanings) annually, and vision exams are generally recommended either annually or bi-annually, especially for those who have vision problems or glaucoma risk. An eye exam can detect serious health problems like glaucoma before symptoms appear, and regular dental exams and cleanings will help to prevent problems such as gingivitis. Hearing tests are typically recommended only if you're experiencing trouble hearing. However, as WebMD points out, "At least 25% of people age 65 to 74 have disabling hearing loss, most of which is treatable. That number increases to 50% after the age of 74." If you feel like you're not hearing as well as you used to, a hearing exam is in order.
While some of these screenings may not sound like a swell time, preventative health is extremely important for men who plan to live a long, healthy, and vibrant life long into their golden years. Spending time in a doctor's office isn't a whole lot of fun for anyone. But as the risks for many diseases and disorders affecting men climb with age, your body – and the people who love you – will thank you 10 to 15 years from now for being so proactive about your health today.