Screening Tests Every Man Should Have

Getting the right screening test at the right time is one of the most important things a man can do for his health. Screenings find diseases early, before you have symptoms, when they're easier to treat. With early detection, colon cancer can be nipped in the bud. Finding diabetes early may help prevent complications such as vision loss and impotence. The tests you need are based on your age and risk factors.

Prostate cancer is the most common cancer found in American men after skin cancer. It tends to be a slow-growing cancer, but there are also aggressive, fast-growing types of prostate cancer. Screening tests can find the disease early, sometimes before symptoms develop, when treatments are most effective.

Screenings for healthy men may include a digital rectal exam (DRE) and possibly a prostate specific antigen (PSA) blood test. Government guidelines recommend against the routine use of the PSA test. The American Cancer Society advises each man to talk with a doctor about the risks and possible benefits of the PSA test. Discussions should begin at:

• 50 for average-risk men
• 45 for men at high risk. This includes African-Americans.
• 40 for men with a strong family history of prostate cancer

This uncommon cancer develops in a man's testicles, the reproductive glands that produce sperm. Most cases occur between ages 20 and 54. The American Cancer Society recommends that all men have a testicular exam when they see a doctor for a routine physical. Men at higher risk (a family history or an undescended testicle) should talk with a doctor about additional screening. Some doctors advise regular self-exams, gently feeling for hard lumps, smooth bumps, or changes in size or shape of the testes.

Colorectal cancer is the second most common cause of death from cancer. Men have a slightly higher risk of developing it than women. The majority of colon cancers slowly develop from colon polyps: growths on the inner surface of the colon. After cancer develops, it can invade or spread to other parts of the body. The way to prevent colon cancer is to find and remove polyps before they turn cancerous.

Screening begins at age 50 in average-risk adults. A colonoscopy is a common test for detecting polyps and colorectal cancer. A doctor views the entire colon using a flexible tube and a camera. Polyps can be removed at the time of the test. A similar alternative is a flexible sigmoidoscopy that examines only the lower part of the colon.

Some patients opt for a virtual colonoscopy -- a CT scan -- or double contrast barium enema -- a special X-ray -- although if polyps are detected, an actual colonoscopy is needed to remove them.

The most dangerous form of skin cancer is melanoma (shown here). It begins in specialized cells called melanocytes that produce skin color. Older men are twice as likely to develop melanoma as women of the same age. Men are also 2-3 times more likely to get non-melanoma basal cell and squamous cell skin cancers than women are. Your risk increases as lifetime exposure to sun and/or tanning beds accumulates; sunburns accelerate risk.

The American Cancer Society and the American Academy of Dermatology recommend regular skin self-exams to check for any changes in marks on your skin including shape, color, and size. A skin exam by a dermatologist or other health professional should be part of a routine checkup. Treatments for skin cancer are more effective and less disfiguring when it's found early.

The risk for high blood pressure increases with age. It's also related to weight and lifestyle. High blood pressure can lead to severe complications without any prior symptoms, including an aneurysm -- dangerous ballooning of an artery. But it can be treated. When it is, you may reduce your risk for heart disease, stroke, and kidney failure. The bottom line: Know your blood pressure. If it's high, work with your doctor to manage it.

Blood pressure readings give two numbers. The first (systolic) is the pressure in your arteries when the heart beats. The second (diastolic) is the pressure between beats. Normal blood pressure is less than 120/80. High blood pressure is 130/80 or higher, and in between those two is prehypertension -- a major milestone on the road to high blood pressure. How often blood pressure should be checked depends on how high it is and what other risk factors you have.

A high level of LDL cholesterol in the blood causes sticky plaque to build up in the walls of the arteries (seen here in orange). This increases your risk of heart disease. Atherosclerosis -- hardening and narrowing of the arteries -- can progress without symptoms for many years. Over time it can lead to heart attack and stroke. Lifestyle changes and medications can reduce this "bad" cholesterol and lower the risk of cardiovascular disease.

The fasting blood lipid panel is a blood test that tells your levels of total cholesterol, LDL "bad" cholesterol, HDL "good" cholesterol, and triglycerides (blood fat). The results tell you and your doctor a lot about what you need to do to reduce the risk of heart disease, stroke, and diabetes. Starting at age 20, men should be screened if they are at increased risk for heart disease. Starting at 35, men need regular cholesterol testing.

One-third of Americans with diabetes don't know they have it. Uncontrolled diabetes can lead to heart disease and stroke, kidney disease, blindness from damage to the blood vessels of the retina (shown here), nerve damage, and impotence. This doesn't have to happen. Especially when found early, diabetes can be controlled and complications can be avoided with diet, exercise, weight loss, and medications.

A fasting blood sugar test, glucose tolerance test, or an AIC all can be used alone or together to screen for diabetes. Healthy adults should have the test every three years starting at age 45. If you have a higher risk, including high cholesterol or blood pressure, you may start testing earlier and more frequently.

HIV is the virus that causes AIDS. It's in the blood and other body secretions of infected individuals, even when there are no symptoms. It spreads from one person to another when these secretions come in contact with the vagina, anal area, mouth, eyes, or a break in the skin. There is still no cure or vaccine. Modern treatments can keep HIV infection from becoming AIDS, but these medications can have serious side effects.

HIV-infected individuals can remain symptom-free for many years. The only way to know they are infected is with a series of blood tests. The first test is called ELISA or EIA. It looks for antibodies to HIV in the blood. It's possible not to be infected and still show positive on the test. So a second test called a Western blot assay is done for confirmation. If you were recently infected, you could still have a negative test result. Repeat testing is recommended. If you think you may have been exposed to HIV, ask your doctor about the tests.

Most newly infected individuals test positive by two months after infection. But up to 5% are still negative after six months. Safe sex -- abstinence or always using latex barriers such as a condom or a dental dam -- is necessary to avoid getting HIV and other sexually transmitted infections. Drug users should not share needles.

This group of eye diseases gradually damages the optic nerve and may lead to blindness -- and significant, irreversible vision loss can occur before people with glaucoma even notice any symptoms. Screening tests look for abnormally high pressure within the eye, to catch and treat the condition before damage to the optic nerve.

Eye tests for glaucoma are based on age and personal risk:

• Under 40: Every 2-4 years
• 40-54: Every 1-3 years
• 55-64: Every 1-2 years
• 65 up: Every 6-12 months

Talk with a doctor about earlier, more frequent screening if you fall in a high risk group, including African-Americans, those with a family history of glaucoma, previous eye injury, or use of steroid medications.