Health screening - men age 65 and older
Health maintenance visit - men - over age 65; Physical exam - men - over age 65; Yearly exam - men - over age 65; Checkup - men - over age 65; Men's health - over age 65; Preventive care exam - men - over age 65
You should visit your health care provider regularly, even if you feel healthy. The purpose of these visits is to:
- Screen for medical issues
- Assess your risk for future medical problems
- Encourage a healthy lifestyle
- Update vaccinations and other preventive care services
- Help you get to know your provider in case of an illness
A fecal occult blood test is a noninvasive test that detects the presence of hidden blood in the stool. Blood in the stool that is not visible is often the first, and in many cases the only, warning sign that a person has colorectal disease, including colon cancer.
Colon cancer is one of the leading causes of cancer-related deaths in the United States. The good news is that earlier diagnosis due to screening tests often leads to a complete cure. Colorectal cancer starts in the large intestine, also known as the colon. Nearly all colon cancers begin as noncancerous, or benign, polyps, some of which may slowly develop into cancer. Screening can detect these polyps and early cancers. Polyps can be removed years before cancer even has a chance to develop. Your doctor can use two types of tools to screen for cancer. The first type is a stool test. Polyps in the colon and small cancers can bleed tiny amounts of blood that you can't see with the naked eye. The most common method to test for the presence of blood is the fecal occult blood test or FOBT. This test checks your stool for small amounts of blood that you may not be able to see. Two other stool tests are the fecal immunochemical test and the stool DNA test. The second type of screening tests involve looking at the lining of the colon. One of these tests is a sigmoidoscopy exam. This test uses a flexible scope to look at the lower portion of your colon. But, because it looks only at the last one-third of the large intestine, it may miss some cancers. So this test is done along with a stool test. A colonoscopy is similar to sigmoidoscopy, but it can see the entire colon. For this test, your doctor will give you instructions for cleansing your bowel. This is called bowel preparation. During the colonoscopy, you’ll receive medicine to make you relaxed and sleepy. Another test your doctor may recommend is a virtual colonoscopy, also called a CT colonography. This test uses a CAT scan and computer software to create a 3-D image of your large intestine. Beginning at age 45, all men and women should have a screening test for colon cancer. Screening options for people with average risk for colon cancer include visual based exams. These could be a colonoscopy every 10 years starting at age 45 or a virtual colonoscopy every 5 years. A Flexible sigmoidoscopy every 5 years or a Flexible sigmoidoscopy every 10 years plus stool testing with FIT done every year. Screening options also include stool based tests. People with average risk should have an FOBT or FIT every year. A colonoscopy is needed if the results are positive, or a Stool DNA test every 1 to 3 years. A colonoscopy is needed if the results are positive. People with certain risk factors for colon cancer may need screening at a younger age, or they may need screening more often. Such people include those with a family history of colon cancer, those with a history of previous colon cancer or polyps, or people with a history of ulcerative colitis or Crohn disease. The death rate for colon cancer has dropped in the past 15 years and this may be due to increased awareness and colon screening. In general, early diagnosis is much more likely to lead to a complete cure.
Blood vessels become less elastic with age. The average blood pressure increases from 120/70 to 150/90 and may persist slightly high even if treated. The blood vessels respond more slowly to a change in body position.
Osteoporosis is a condition characterized by progressive loss of bone density, thinning of bone tissue and increased vulnerability to fractures. Osteoporosis may result from disease, dietary or hormonal deficiency or advanced age. Regular exercise and vitamin and mineral supplements can reduce and even reverse loss of bone density.
Prostate cancer is the most common cancer in men in the United States. Prostate cancer forms in the prostate gland, and can sometimes be felt on digital rectal examination. This is one of the purposes of the digital rectal exam.
Information
Even if you feel fine, you should still see your provider for regular checkups. These visits can help you avoid problems in the future. For example, the only way to find out if you have high blood pressure is to have it checked regularly. High blood sugar and high cholesterol levels also may not have any symptoms in the early stages. A simple blood test can check for these conditions.
There are specific times when you should see your provider or receive specific health screenings. The US Preventive Services Task Force publishes a list of recommended screenings. Below are screening guidelines for men age 65 and older.
ABDOMINAL AORTIC ANEURYSM SCREENING
- If you are age 65 to 75 and have smoked, you should have an ultrasound to screen for abdominal aortic aneurysms.
- Other men should discuss this screening with their provider.
BLOOD PRESSURE SCREENING
Have your blood pressure checked at least once every year. Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked. You can also check your blood pressure using the automated machines at some local grocery stores and pharmacies.
Ask your provider if you need your blood pressure checked more often if
- You have diabetes, heart disease, kidney problems, or are overweight or have certain other conditions
- You have a first degree relative with high blood pressure
- You are Black
- Your blood pressure top number is from 120 to 129 mm Hg, or the bottom number is from 70 to 79 mm Hg
If the top number is 130 mm Hg or greater, but lower than 140 mm Hg or the bottom number is 80 mm Hg or greater but lower than 90 mm Hg, this is considered stage 1 hypertension. Readings above these are considered stage 2 hypertension. Schedule an appointment with your provider to learn how you can reduce your blood pressure. Record your blood pressure numbers and bring this information to share with your provider.
CHOLESTEROL SCREENING
If your cholesterol level is normal, your cholesterol should be checked every 5 years.
Repeat cholesterol testing or other additional monitoring should take place:
- Every 5 years for men with normal cholesterol levels
- More often if changes occur in lifestyle (including weight gain and diet)
- More often if you have diabetes, high blood pressure, heart disease, stroke, or blood flow problems in the legs or feet, or certain other conditions
Your provider may recommend testing more often if you are taking medicines to control high cholesterol.
COLORECTAL CANCER SCREENING
Until age 75, you should have screening for colorectal cancer on a regular basis. Several tests are available for colorectal cancer screening:
- A stool-based fecal occult blood (FOBT) or fecal immunochemical test (FIT) every year (colonoscopy is needed if results are positive)
- A stool DNA-FIT test every 1 to 3 years (colonoscopy is needed if results are positive)
- Flexible sigmoidoscopy every 5 years or every 10 years with stool occult blood testing with FOBT or FIT every year
- CT colonography (virtual colonoscopy) every 5 years
- Colonoscopy every 10 years
You may need a colonoscopy more often if you have risk factors for colorectal cancer, such as:
- Ulcerative colitis
- A personal or family history of cancer of the colon or rectum
- A history of growths in your colon called adenomatous polyps
- A family history of inherited colorectal cancer syndromes such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer (HNPCC)
- People ages 76 through 85 should talk with their health care provider about whether to continue to get screened. People ages 86 and older no longer need colorectal cancer screening.
DENTAL EXAM
- Go to the dentist once or twice every year for an exam and cleaning. Your dentist will evaluate if you have a need for more frequent visits.
PREDIABETES AND TYPE 2 DIABETES SCREENING
You should be screened for prediabetes and type 2 diabetes every 3 years up to age 70 if you are overweight or have obesity.
You should be tested more often if you have other risk factors for diabetes, such as:
- You have a first-degree relative with diabetes
- You have high blood pressure, prediabetes, or a history of heart disease
EYE EXAM
- Have an eye exam every year. Your provider may recommend more frequent eye exams if you have vision problems or glaucoma risk.
- Have an eye exam that includes an examination of your retina (back of your eye) at least every year if you have diabetes.
HEARING TEST
- Have your hearing tested if you have symptoms of hearing loss.
IMMUNIZATIONS
Commonly needed vaccines include:
- Flu shot: get one every year
- COVID-19 vaccine: ask you provider what is best for you
- Pneumococcal vaccines: you should receive the appropriate pneumococcal vaccines
- Shingles 2 doses of (herpes zoster) vaccine at or after age 50
- Tetanus-diphtheria and acellular pertussis (Tdap) vaccine: have as one of your tetanus-diphtheria vaccines if you did not receive it as an adolescent
- Tetanus-diphtheria: have a booster (Td or Tdap) every 10 years
INFECTIOUS DISEASE SCREENING
Screening for hepatitis C:
- All adults ages 18 to 79 should get a one-time test for hepatitis C.
Screening for human immunodeficiency virus (HIV): all people ages 15 to 65 should get a one-time test.
Depending on your lifestyle and medical history, you may need to be screened for infections such as syphilis, chlamydia, and other infections.
LUNG CANCER SCREENING
You should have an annual screening for lung cancer with low-dose computed tomography (LDCT) if:
- You are age 50 to 80 years AND
- You have a 20 pack-year smoking history AND
- You currently smoke or have quit within the past 15 years
OSTEOPOROSIS SCREENING
- If you have risk factors for osteoporosis, you should discuss screening with your provider.
- Risk factors can include long-term steroid use, low body weight, smoking, heavy alcohol use, having a fracture after age 50, or a family history of hip fracture or osteoporosis.
PHYSICAL EXAMS
All adults should visit their provider from time to time, even if they are healthy. The purpose of these visits is to:
- Screen for diseases
- Assess risk of future medical problems
- Encourage a healthy lifestyle
- Update vaccinations and other preventive care services
- Maintain a relationship with a provider in case of an illness
In addition:
- Your blood pressure should be checked at least every year.
- Your height, weight, and body mass index (BMI) should be checked at every exam.
During your exam, your provider may ask you about:
- Depression and anxiety
- Diet and exercise, including exercises to improve your balance and reduce your risk of falling
- Alcohol and tobacco use
- Safety, such as use of seat belts and smoke detectors and intimate partner violence
- Whether you have had any falls or are afraid of falling
- Your medicines and risk for interactions
PROSTATE CANCER SCREENING
If you're 55 through 69 years old, before having the test, talk to your provider about the pros and cons of having a prostate specific antigen (PSA) blood test. Ask about:
- Whether screening decreases your chance of dying from prostate cancer.
- Whether there is any harm from prostate cancer screening, such as side effects from testing or overtreatment of cancer when discovered.
- Whether you have a higher risk of prostate cancer than others.
For men 70 or older, most recommendations are against screening.
If you choose to be tested, the PSA blood test is repeated over time (yearly or less often), though the best frequency is not known.
- Prostate physical examinations are no longer routinely done on men with no symptoms.
SKIN EXAM
- Have had skin cancer before
- Have close relatives with skin cancer
- Have a weakened immune system
TESTICULAR EXAM
- The US Preventive Services Task Force (USPSTF) now recommends against performing testicular self-exams. Doing testicular self-exams has been shown to have little to no benefit.
References
American Academy of Ophthalmology website. Clinical statement: Comprehensive adult medical eye examination PPP 2020.
American Dental Association website. Your top 9 questions about going to the dentist - answered.
American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2024. Diabetes Care. 2024;47(Suppl 1):S20-S42. PMID: 38078589
Barton MB, Wolff TA. The preventive health visit. In: Goldman L, Cooney K, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 12.
Centers for Disease Control and Prevention website. Vaccines & Immunizations.
Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines [published correction appears in J Am Coll Cardiol. 2019;25;73(24):3237-3241]. J Am Coll Cardiol. 2019;73(24):e285-e350. PMID: 30423393
Meschia JF, Bushnell C, Boden-Albala B, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(12):3754-3832. PMID: 25355838
Mora S, Libby P, Ridker PM. Primary prevention of cardiovascular disease. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 25.
US Preventive Services Task Force website. Falls prevention in community-dwelling older adults: Interventions.
US Preventive Services Task Force website. Final recommendation statement. Colorectal cancer: Screening.
US Preventive Services Task Force website. Final recommendation statement. Hepatitis C virus infection in adolescents and adults: Screening.
US Preventive Services Task Force website. Final recommendation statement. Human immunodeficiency virus (HIV) infection: Screening.
US Preventive Services Task Force website. Hypertension in adults: Screening.
US Preventive Services Task Force website. Final recommendation statement: Lung cancer: Screening.
US Preventive Services Task Force website. Final recommendation statement: Osteoporosis to prevent fracture: Screening.
US Preventive Services Task Force website. Prediabetes and type 2 diabetes: Screening.
US Preventive Services Task Force website. Final recommendation statement. Prostate cancer: Screening.
US Preventive Services Task Force website. Skin cancer: Screening.
US Preventive Services Task Force website. Testicular cancer: Screening.
Whelton PK, Carey RM, Mancia G, Kreutz R, Bundy JD, Williams B. Harmonization of the American College of Cardiology/American Heart Association and European Society of Cardiology/European Society of Hypertension Blood Pressure/Hypertension Guidelines: Comparisons, Reflections, and Recommendations. Circulation. 2022;146:868–877. PMID: 35950927
Version Info
Last reviewed on: 5/20/2024
Reviewed by: Jacob Berman, MD, MPH, Clinical Assistant Professor of Medicine, Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
