Facts you should know about disease prevention in men
Routine screening tests can help detect diseases while they are in an early stage.
Routine screening tests are part of basic prevention medicine. All of the following screening tests are commonly available through your doctor. Take an active role in your own health care and discuss screening tests with your doctor early in life. Following is a list of diseases for which screening is recommended along with mention of the commonly used screening tests, which usually are safe and simple and can help detect many diseases before they become harmful.
High blood pressure (hypertension)
About one-sixth of all Americans have high blood pressure and the incidence of this disease increases with age. African-Americans are more likely than other races to have high blood pressure.
High blood pressure can cause arterial disease (atherosclerosis) that can lead to heart attack, congestive heart failure, stroke, and kidney failure.
Tests or procedures for high blood pressure
Blood pressure measurements
- High blood pressure: systolic >140, and/or diastolic >90
- Borderline high blood pressure: systolic 130-140, and/or diastolic 85-90
Who to test and how often
- How often blood pressure should be checked depends on how severely elevated the blood pressure is, and also depends on the number of other heart attack and stroke risk factors that are present.
- Adults with most recent normal blood pressure of systolic <130 and diastolic <85 should be checked at least every other year.
- Adults with borderline high blood pressures (systolic 130-140 or diastolic 85-90) should be rechecked in 3-6 months.
Benefits of early detection
- High blood pressure can cause arterial disease (atherosclerosis) that can lead to heart attack, congestive heart failure, stroke, and kidney failure.
- High blood pressure can cause diseases without any early warning symptoms.
- There is good evidence that treatment of high blood pressure can reduce the risk of heart diseases, stroke, and kidney failure.
- There is good evidence that adults with borderline blood pressures can benefit from blood pressure lowering. Therefore, you should discuss with your doctor measures that you can take to reduce blood pressure, which can include reducing salt intake, exercise, and stress management.
Prostate Cancer Screening
There are no standard or routine screening tests for prostate cancer. Studies are being done to find ways to make prostate-specific antigen (PSA) testing more accurate for early cancer detection. A PSA test or digital rectal exam (DRE) may be able to detect prostate cancer at an early stage:
- DRE: It is an exam of the rectum (end part of the bowel). The doctor inserts a lubricated, gloved finger into the lower part of the rectum to feel the prostate for lumps or anything else that seems unusual.
- PSA test: It is a test that measures the level of PSA in the blood. PSA is a substance made mostly by the prostate that may be found in an increased amount in the blood of men who have prostate cancer. The PSA level may also be high in men who have an infection or inflammation of the prostate or benign prostatic hyperplasia (an enlarged, but non-cancerous, prostate). A free PSA is a more precise marker for those who are at a high-risk case.
Read more about prostate cancer screening »
Hypercholesterolemia (hyperlipidemia, dyslipidemia)
Elevated LDL cholesterol or low HDL cholesterol increases the risk of developing atherosclerosis ("hardening of the arteries"). Atherosclerosis can begin to develop in adolescence and progress without any symptoms for many years and it leads to heart attack and stroke later in life.
Hyperlipidemia is a common and treatable cause of atherosclerosis. Atherosclerosis is the most common cause of death in both men and women in developed countries. The goal is to diagnose and retard or reverse atherosclerosis while it is still in a silent early state before complications occur.
Tests or procedures for hypercholesterolemia
Blood lipid panel that includes:
- total cholesterol,
- LDL cholesterol, "bad" cholesterol,
- HDL cholesterol, "good" cholesterol,
- total/HDL cholesterol ratio, and
- triglycerides.
Who to test and how often
- All adults over 20 should have a lipid panel every 5 years if LDL cholesterol is less than 130, and every 1-3 years if LDL cholesterol is borderline (between 130 and 160). LDL is the part of the cholesterol panel that is most significant when determining treatment, as well as determining how often lipid panels should be checked. Tests may be carried out more frequently in those with risk factors for heart or vascular disease or when medically indicated.
Benefits of early detection
- Elevated LDL cholesterol or low HDL cholesterol increases the risk of developing atherosclerosis (hardening of arteries).
- Atherosclerosis can begin to develop in adolescence and progress without any symptoms for many years. It leads to heart attack and stroke later in life.
- There is good evidence that lowering elevated or borderline LDL cholesterol and increasing low HDL is beneficial in heart attack prevention and in some cases stroke prevention in subjects with or without known atherosclerosis.
- Treatment of elevated or borderline cholesterol is multi-dimensional. Individuals should discuss potential treatments with their doctor, including nutritional planning (regarding total calorie, total fat, saturated fat, and cholesterol intake) as well as weight reduction and regular exercise.
Type II diabetes mellitus
Diabetes mellitus is a condition with elevated blood sugar level (hyperglycemia) due to impaired utilization of insulin, decreased production of insulin, or both.
Diabetes is the seventh leading cause of death in the United States. An estimated 18% of all Americans over 65 years of age have diabetes. Over ten million Americans have been diagnosed with diabetes, and at least half as many more are thought to have diabetes that is undiagnosed. Many more have a condition that precedes diabetes, referred to as prediabetes, characterized by elevated blood sugar levels but to a lesser degree than is present in those with diabetes.
Diabetes is the leading cause of new cases of blindness in adults aged 20-74 years, the leading cause of chronic kidney failure, and the leading cause of lower extremity amputations not related to injury. Individuals with diabetes are two to four times as likely to have a heart attack or stroke as are those without diabetes.
Tests or procedures for type II diabetes mellitus
Tests for diabetes mellitus
- Fasting blood sugar (blood sugar test after at least 8 hours without calories), normal level less than 126 mg/dl
- Two hour postprandial blood sugar (blood sugar test 2 hours after a meal), normal level less than 140mg/dl
Who to test and how often
Healthy adults over 45 years should have fasting blood glucose level checked every 3 years.
Adults at a higher than normal risk of developing diabetes mellitus should be checked more frequently than every three years; these individuals include:
- People who are overweight
- Blood relatives with type II diabetes
- Certain ethnic groups such as certain Native Americans, African-Americans, Hispanics, and Asians
- Individuals with prediabetes
- Low HDL cholesterol (35 mg/dl. or less) or elevated triglyceride level (over 250 mg/dl)
Benefits of early detection
- Diabetes mellitus can cause atherosclerosis that can lead to heart attack, stroke, and compromise of arterial circulation to the legs and feet. Diabetes mellitus also can damage the nerves, eyes, and kidneys.
- Diabetes mellitus commonly causes organ damage without symptoms until extensive damage is present.
- There is good evidence that controlling hyperglycemia in diabetes with medications, diet, weight control, and regular exercise can slow the development of atherosclerosis and heart, eye, nerve, and kidney damage.
- There is good evidence that curtailing total calorie intake (especially intake of processed starches, sugar and sweets), regular exercise, and losing excess weight can help prevent the development of type II diabetes mellitus, especially in adults at higher than normal risk of developing diabetes.
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HIV (human immunodeficiency virus)
HIV is the virus that causes AIDS (acquired immune deficiency syndrome). While modern anti-HIV medications have significantly improved long-term survival and quality of life of HIV infected individuals, there is still no cure or vaccine. HIV infection is still eventually lethal in everyone who is infected. Therefore, preventing the spread of HIV is the most important step in preventing illness and death due to HIV infection.
Tests procedures for human immunodeficiency virus (HIV)
Screening tests
- Screening blood test for antibodies to HIV is called an ELISA test. Confirmatory test for antibodies to HIV is called a Western blot.
- HIV-infected individuals can remain free of symptoms for many years; they will know if they are infected ONLY if a blood test for HIV is done. HIV testing can be performed by a physician or at a testing center.
Who should be tested for HIV
The following individuals should be routinely offered HIV testing:
- pregnant women;
- individuals with occupational exposure to HIV (health care workers and researchers working with HIV infected individuals or tissues or blood products containing the HIV virus);
- individuals with high-risk sexual behavior (multiple sexual partners, unprotected intercourse), or who practice needle-sharing;
- anyone requesting HIV testing;
- individuals with active tuberculosis, unexplained fevers, low white blood cell counts, or who have been diagnosed with a sexually-transmitted infection; and
- routine Screening is gaining more and more support as HIV is becoming a treatable disease.
Most infected individuals will develop a positive HIV blood test within 3 months of being exposed to HIV. If the HIV test at 3 months is negative and there are risk factors for infection, the test should be repeated in another 3 months.
Benefits of early detection
- Theoretically, early treatment with anti-HIV medications may help the body’s immune system fight the virus. So far, early treatment cannot cure or eradicate the virus. Therefore, early detection is most important to prevent the spread of the virus.
- Early detection, if it leads to life style changes , can also decrease the spread of the disease.
- The virus is present in the blood, genital, and other body secretions of virtually all infected individuals, regardless of whether or not they have symptoms. The HIV virus is spread from one person to another when these secretions come in contact with the vagina, anal area, mouth, or eyes, or with a break in the skin, such as from a cut, bruise, sore, or puncture by a needle. Sexual transmission of HIV has been described from men to men, men to women, women to men, and women to women through vaginal, anal, and oral sex.
Prevention of spread of HIV
- Abstinence from sex until both partners are certain that they are not infected (for example both partners test negative for HIV antibody after the last potential exposure). While most newly infected individuals test positive by two months after infection, up to 5% are still negative after six months with routine testing. If abstinence is not possible, use latex barriers such as a condoms and a dental dam (piece of latex that prevents vaginal secretions from coming in direct contact with the mouth.)
- Avoid sharing of needles, razor blades, and toothbrushes.
- Health care workers who experience a needle stick or exposure of the eyes, mouth, or injured skin from an infected person must take anti-HIV medication in order to reduce the risk of developing infection.
Cancer of colon and rectum/polyps of colon and rectum
Colorectal cancer is the second most common cause of death from cancer overall, and ranks third in both women (after lung and breast cancer) and men (after lung and prostate cancer).
Scientists believe that majority of the colon cancers develop from colon polyps (precancerous growths on the inner surface of the colon). After turning cancerous, the cells can then invade or spread (metastasize) to other parts of the body. If these polyps are identified and removed before they turn cancerous, colon cancer can be prevented. Colon cancer is curable if it is surgically removed before the cancer spreads.
Tests or procedures for colon polyps/colon cancer
- Stool occult blood test: A fecal occult blood test is a chemical test to detect trace amounts of blood in stool. It is inexpensive and easy, though not always accurate. Some cancers are not detected with this test, and many positive tests are due to conditions other than cancer.
- Flexible sigmoidoscopy: A flexible sigmoidoscopy is a relatively quick and easy office procedure that allows direct visualization and biopsy of suspicious lesions from the distal (end) portion of the colon. The drawbacks include some discomfort and is not as thorough as colonoscopy.
- Optical colonoscopy:Optical colonoscopy is the isualization of the entire colon. This is the most complete and thorough test, but often requires IV sedation, much more expensive, and is not covered by some insurance for screening.
- Virtual colonoscopy:Virtual colonoscopy is a less invasive procedure utilizing CT scan to construct virtual images of the colon that are similar to the views of the colon obtained by direct colonoscopy. The drawbacks to virtual colonoscopy are that it cannot remove polyps, and is not as reliable as optical colonoscopy in detecting small polyps, finding flat cancers, or polyps that are not protruding.
Who to test and how often
- All healthy adults should have stool occult blood tests and flexible
sigmoidoscopy at age 50 and flexible sigmoidoscopy every 5 years. - Alternatively, instead of flexible sigmoidoscopy, all healthy persons can undergo screening colonoscopy at age 50 and then every 10 years if no prior history of polyps or cancer.
- Those at higher risk for colon cancer (individuals with family history of colon polyps and cancer, long standing ulcerative colitis, or prior personal history of colon polyps or cancer need colonoscopy earlier and at shorter intervals.
Benefits of early detection
Stool occult blood test, flexible sigmoidoscopy, and colonoscopy are documented to reduce colon cancer mortality by:
- Preventing colon cancer by identifying and removing polyps before they become cancerous; and
- Increasing the cancer cure rate by identifying early cancer at a treatable stage before the cancer has spread (metastasized).
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Prostate cancer
Prostate cancer is the most commonly occurring non-skin cancer in men in the United States. Among the non-skin cancers, it is also the second most frequent cause of cancer death in this population.
Although screening tests (see below) are available, there is no scientific consensus on effective measures for reducing the incidence of prostate cancer. Additionally, there is no agreement on the effectiveness of screening or that the potential benefits of screening tests outweigh the risks.
Tests or procedures for prostate cancer
- Digital rectal examination (DRE)
- PSA (prostate specific antigen) blood test
Who to test and how often
The U.S. Preventive Services Task Force (USPSTF) has concluded that the current evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening in men younger than age 75 years and that screening should not be carried out in men age 75 years or older.
The controversy regarding screening tests
The purpose of the screening is to detect early, tiny, or even microscopic cancers that are confined to the prostate gland. Early treatment of these malignancies (cancers) can stop the growth, prevent the spread, and possibly cure the cancer. However, the evidence is not conclusive that screening and treatment of early and localized prostate cancer is beneficial; some elderly men may live with prostate cancer for many years and die from other conditions rather than from the prostate cancer, and the measures undertaken for diagnosis and treatment of prostate cancer (surgery, radiation therapy, chemotherapy, or hormones) can have side effects and serious complications such as pain associated with the biopsy procedure, erectile dysfunction, urinary incontinence, bowel dysfunction, and death. For this reason, screening of men over age 75 years is not recommended, and younger men must consider the potential benefits and risks of prostate cancer screening and discuss these with their health care practitioner before undergoing screening tests.
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Glaucoma
Glaucoma is a condition with abnormally elevated intra-ocular pressures (pressure within the eyes.)
Tests or procedures for glaucoma
Tonometry: (eye pressure measurements) an eye care specialist is required for adequate examination.
- A check-up for vision does not always measure intra-ocular pressure.
- Measurement of intra-ocular pressure should be a standard component of a comprehensive eye examination.
Who to test and how often
The American Academy of Ophthalmology’s recommended intervals for eye exams, including glaucoma screening, are:
- Age 20-29: Individuals of African descent or with a family history of glaucoma should have an eye examination every three to five years. Others should have an eye exam at least once during this period.
- Age 30-39: Individuals of African descent or with a family history of glaucoma should have an eye examination every two to four years. Others should have an eye exam at least twice during this period.
- Age 40-64: Every two to four years.
- Age 65 or older: Every one to two years.
Benefits of early detection
- Glaucoma causes extensive damage to the retina and irreversible loss of vision without waning symptoms and before the individual becomes aware of loss of vision.
- There is good evidence that treatment of elevated eye pressure in glaucoma can prevent blindness.
Melanoma and other skin cancers
Melanoma is the most serious form of skin cancer
Tests or procedures for melanoma and other skin cancers
- Total body skin examination
Who to test and how often
The American Cancer Society recommends a skin check every 3 years between the ages of 20 and 40, and a skin check annually over age 40.
Adults with higher than normal risk for melanoma should be particularly vigilant to include individuals who:
- have a family history of melanoma;
- are middle-aged adults with frequent sun exposure;
- have a history of serious or frequent sunburn (childhood sunburn is particularly risky);
- have more than 50 moles; and
- have fair skin.
See a doctor if the mole has the following characteristics:
- diameter more than 6mm;
- asymmetric (meaning an uneven shape);
- irregular border; and
- variable color pattern, meaning many colors or unusual colors, such as blue or black.
Benefits of early detection
Skin cancer is the most common cancer. Even though the benefit of skin cancer screening is uncertain (so far research has not shown that death from skin cancer can be decreased after a regular screening program is instituted), early treatment of skin cancer can be effective. Melanomas may be detected at a thinner stage with regular skin exams. Thinner melanomas are more successfully treated than are thick ones that have grown downward into the deeper portions of the skin.
Bladder cancer
Tests or procedures for bladder cancer
- Urine examination for blood cells. This may be done by dipstick tests with confirmation by microscopic examination of the urine, or by initial microscopic examination.
- Bladder cancer can cause either gross hematuria (visible blood in the urine) or microscopic hematuria (blood in the urine only visible with a microscope). It is important to note that bladder cancer is only one of many causes of blood in the urine.
Who to test and how often
All individuals who are former or current cigarette smokers or who have a history of occupational exposure to certain chemicals often used in the dye, leather, tire and rubber industries should have a urine examination for blood periodically after age 60.
Benefits of early detection
- Early bladder cancer may produce no symptoms and no visible bleeding in the urine, and blood in the urine commonly microscopic.
- Treatment can be effective if the cancer is detected early, and survival is strongly associated with stage of disease at time of treatment.
- Cessation of cigarette smoking is always advisable.