Health screenings for men age 65 and older

Definition

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
• Help you get to know your provider in case of an illness

Alternative Names

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

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 local grocery stores and pharmacies.

Ask your doctor 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

CHOLESTEROL SCREENING

If your cholesterol level is normal, your cholesterol should be checked every 5 years.

You should have repeat testing sooner if:

• Changes occur in your lifestyle (including weight gain and diet)
• You have high cholesterol, diabetes, heart disease, kidney problems, or certain other health conditions

COLORECTAL CANCER SCREENING

Until age 75, you should have screening for colorectal cancer on a regular basis. If you are age 76 or older, you should ask your provider if you need to be screened. Several tests are available for colorectal cancer screening:

• A stool-based fecal occult blood (gFOBT) or fecal immunochemical test (FIT) every year
• A stool sDNA-FIT test every 1 to 3 years.
• Flexible sigmoidoscopy every 5 years or every 10 years with stool testing with 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

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.

DIABETES SCREENING

You should be screened every 3 years.

You may be tested more often if you have other risk factors for diabetes, such as:

• A first-degree relative with diabetes
• You are overweight or have obesity, high blood pressure, prediabetes, or a history of heart disease

EYE EXAM

• Have an eye exam every 1 to 2 years.
• 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
• Pneumococcal vaccine: you should receive this vaccine
• 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 (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 are age 50 to 70 and 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
• A family history of hip fracture or osteoporosis

PHYSICAL EXAMS

• Your blood pressure should be checked at least every year.
• Your provider will recommend checking your cholesterol every 5 years or more often if you have diabetes or other conditions.
• 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
• 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 PSA 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 examinations are no longer routinely done on men with no symptoms.

SKIN EXAM

• Your provider may check your skin for signs of skin cancer, especially if you're at high risk.
• People at high risk include those who have had skin cancer before, have close relatives with skin cancer, or 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

Advisory Committee on Immunization Practices. Recommended immunization schedule for adults aged 19 years or older, United States, 2022. www.cdc.gov/vaccines/schedules/hcp/imz/adult.html. Updated February 17, 2022. Accessed April 27, 2022.

American Academy of Ophthalmology website. Clinical statement: Frequency of ocular examinations - 2015. www.aao.org/clinical-statement/frequency-of-ocular-examinations. Updated March 2015. Accessed August 9, 2022.

American Dental Association website. Your top 9 questions about going to the dentist - answered. www.mouthhealthy.org/en/dental-care-concerns/questions-about-going-to-the-dentist. Accessed August 9, 2022.

American Diabetes Association Professional Practice Committee. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022 Jan 1;45(Suppl 1):S17-S38. PMID: 34964875 pubmed.ncbi.nlm.nih.gov/34964875/.

Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 12.

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 Jun 25;73(24):3237-3241]. J Am Coll Cardiol. 2019;73(24):e285-e350. PMID: 30423393 pubmed.ncbi.nlm.nih.gov/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 pubmed.ncbi.nlm.nih.gov/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.

Moyer VA; US Preventive Services Task Force. Screening for lung cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160(5):330-338. PMID: 24378917 pubmed.ncbi.nlm.nih.gov/24378917/.

Studenski S, Van Swearingen J. Falls. In: Fillit HM, Rockwood K, Young J, eds. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Philadelphia, PA: Elsevier; 2017:chap 103.

US Preventive Services Task Force website. A and B recommendations. www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations. Accessed August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement. Colorectal cancer: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening. Published May 18, 2021. Accessed August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement. Hepatitis C virus infection in adolescents and adults: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/hepatitis-c-screening. Published March 2, 2020. Accessed August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement. Human immunodeficiency virus (HIV) infection: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/human-immunodeficiency-virus-hiv-infection-screening. Published June 11, 2019. Accessed August 9, 2022.

US Preventive Services Task Force website. Hypertension in adults: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/hypertension-in-adults-screening. Published April 27, 2021. Accessed August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement: Lung cancer: Screening. Updated March 9, 2021. www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening. Accessed August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement: Osteoporosis to prevent fracture: Screening. Updated June 26, 2018. www.uspreventiveservicestaskforce.org/uspstf/recommendation/osteoporosis-screening. Accessed August 9, 2022.

US Preventive Services Task Force website. Prediabetes and type 2 diabetes: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type-2-diabetes. Published August 24, 2021. Accessed August 9, 2022.

US Preventive Services Task Force website. Final recommendation statement. Prostate cancer: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening. Published May 8, 2018. Accessed August 9, 2022.

US Preventive Services Task Force website. Skin cancer: Screening. www.uspreventiveservicestaskforce.org/uspstf/draft-update-summary/skin-cancer-screening-1. Updated March 19, 2021. Accessed August 9, 2022.

US Preventive Services Task Force website. Testicular cancer: Screening. www.uspreventiveservicestaskforce.org/uspstf/recommendation/testicular-cancer-screening. Published April 15, 2011. Accessed August 9, 2022.

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: 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. 2018 May 15;71(19):2275-2279]. J Am Coll Cardiol. 2018;71(19):e127-e248. PMID: 29146535 pubmed.ncbi.nlm.nih.gov/29146535/.

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