Screening Tests for Men Archive


Why you need an annual wellness visit

The once-a-year appointment can reveal vital health information for both you and your doctor.

It's usually covered by your health insurance, it doesn't take much time, and it's a great way to learn about your present and future health.

While men often call it the yearly physical, the annual ritual is better named a wellness visit or preventive health appointment. Whatever you call it, men should still have one every year as it remains an important part of primary care, according to Dr. Asaf Bitton, executive director of Ariadne Labs and primary care physician at Harvard-affiliated Brigham and Women's Hospital.

Should you get a home genetic test?

Direct-to-consumer tests may help predict risks to your future health. But are they worth the cost and trouble?

 Image: © jxfzsy/Getty Images

Direct-to-consumer (DTC) genetic test kits are a popular way to identify a person's ancestral history, but the technology may also reveal whether someone is at risk for specific diseases and conditions, like Alzheimer's disease, heart disease, and even cancer.

"More and more people want to explore their own medical data, and a DTC genetic test is one way to begin to understand some aspects of your future health," says Dr. Robert Green, a medical geneticist at the Harvard-affiliated Brigham and Women's Hospital and director of the Genomes2People Research Program. "Yet it is important to realize that DTC testing is not the same as genetic testing in a medical context, and is not a comprehensive examination of your DNA."

Prostate screening guideline highlights patient choice

In the journals

 Image: © jarun011/Getty Images

The U.S. Preventive Services Task Force recently updated its guideline for prostate-specific antigen (PSA) screening for prostate cancer.

The group now recommends that for men ages 55 to 69, screening should be an individual choice, and a man should discuss the pros and cons with his doctor before making a decision. The report, published online May 8, 2018, by The Journal of the American Medical Association, differs from the 2012 guidelines that recommended against screening for all men.

Do I ever need a stress test?

On call

Q. I am 65 years old and in good health, and I see my doctor once a year for an annual exam. Should I request a stress test at my next physical?

A. Although heart disease is common in men, routine cardiac stress testing is not recommended for otherwise healthy men. It may seem counterintuitive not to look for heart disease in healthy men, especially when many people know someone who unexpectedly had a heart attack or even died suddenly from a heart problem. Yet, stress testing does not accurately identify men at risk for sudden cardiac death.

Heart scans: Why and when you might consider one

Coronary artery calcium tests can reveal early signs of heart disease. But they're not appropriate for everyone.

 Image: © Monkey Business Images/Thinkstock

A special x-ray scan can show specks of calcium inside the walls of the heart's arteries within a matter of minutes. Known as a coronary artery calcium (CAC) scan, it offers one way to predict a person's future risk of heart disease.

However, having this test makes sense only if the results would affect a person's medical treatment. For the most part, that means it's useful primarily for people who are wavering about whether to take a cholesterol-lowering statin drug, says Dr. Ron Blankstein, a cardiovascular imaging specialist and preventive cardiologist at Harvard-affiliated Brigham and Women's Hospital.

New way to use PSA test might identify men who need aggressive prostate cancer treatment

In the journals

Prostate-specific antigen (PSA) tests are used to help identify men who may have a higher risk of prostate cancer. But a study published online Jan. 12, 2017, by JAMA Oncology, describes a new way to use PSA that may pinpoint men who are likely to die early from prostate cancer that returns after initial treatment.

The researchers used data from a randomized trial of 157 men whose localized cancer was treated with either radiation alone or radiation along with six months of androgen deprivation therapy. The men were then followed for 16 years.

The family history of cancer

If cancer runs in your family, there is much you can do to recognize your potential risk and catch the disease before it strikes.

Image: filipefrazao/Thinkstock

You may remember stories of your father's military service and your mother's hometown, but how much do you know about your family's medical history? In particular, do you know whether anyone on your mom or dad's side ever had cancer?

"Family history can be one of the first lines of defense in preventing cancer," says Dr. Huma Q. Rana, clinical director of the Center for Cancer Genetics and Prevention at Harvard-affiliated Dana-Farber Cancer Institute.

New approach identifies returning prostate cancer

Researchers have mapped patterns of prostate cancer recurrence following surgery, which may help doctors find the best way to treat men whose cancer has returned. About 30% of men who have prostate cancer surgery will have a recurrence, according to the study in the Journal of Urology. 

Beware of low diastolic readings when treated for high blood pressure

New research has linked heart tissue damage to blood pressure treatments that drive diastolic pressure (the bottom number in a reading) too low. 

Top screenings to avoid cancer

Talk to your doctor to nail down your cancer risk, and check this list to see which tests may help save your life.

 Images: Monkey Business Images/Thinkstock

Recommendations for cancer screenings sometimes change, and it can be confusing about which tests you need and when. "It's best to talk to your doctor about your cancer risk factors and family history, learn which screenings are right for you, and then develop and stick to a screening schedule," says Dr. JoAnn Manson, chief of preventive medicine at Harvard-affiliated Brigham and Women's Hospital.

Routine screenings

Other screening tests

Some screenings are not recommended routinely but may be important based on your cancer risk.

Lung cancer. The American Lung Association recommends low-dose computed tomography to detect early signs of lung cancer for heavy smokers ages 55 to 74 who have a 30 pack-year smoking history (equivalent to one pack per day for 30 years) and who have smoked within the past 15 years. The USPSTF extends the screening age to 80. If you're not in this group, you should not have routine screening; the risk from radiation exposure and potential unnecessary follow-up testing is not worth the small chance of benefit.

Skin cancer. The USPSTF says there's not enough evidence to recommend regular visual skin exams by a doctor to screen for skin cancer, and that screenings increase the risk for unnecessary biopsies, overdiagnosis, and overtreatment. The American Academy of Dermatology suggests that all people conduct skin self-exams and report any unusual spots on their skin to a dermatologist.

People with an increased risk for melanoma, the deadliest form of skin cancer, should talk to a dermatologist about how often they should get a skin exam.

What about a PSA test?

One of the most debated screenings is the blood test used to look for prostate cancer in men. It measures the level of a protein in the blood called prostate-specific antigen (PSA), which can rise when prostate cancer develops. In 2012, the USPSTF recommended against routine PSA tests, saying they raise the risk of unnecessary follow-up testing and treatment, which can cause problems such as incontinence and erectile dysfunction.

Recent evidence shows that fewer men are being screened as a result. "The sentiment among many physicians now is against offering routine PSA testing for men, especially when nearly every study has not shown any tangible benefits for those who have undergone testing and treatment," says oncologist Dr. Marc Garnick, editor in chief of Harvard's Annual Report on Prostate Diseases.

The American Cancer Society suggests that men 50 or older (at average risk for prostate cancer) make the decision about screening with their doctor, but only if they have a life expectancy of at least 10 years, and only if they have been advised about the uncertainties, risks, and potential benefits of prostate cancer screening.


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