From the Guidelines
Men should undergo regular health screenings, including discussions about prostate cancer screening starting at age 50, or 45 for those at higher risk, with PSA tests and digital rectal exams, as part of a comprehensive approach to detect potential health issues early and improve outcomes. The recommended health screenings for men include:
- Annual blood pressure checks starting at age 18
- Cholesterol screening every 4-6 years beginning at age 20, more frequently if at risk
- Diabetes screening every 3 years starting at age 45, or earlier with risk factors
- Colorectal cancer screening starting at age 45 through colonoscopy every 10 years or other methods like stool tests
- Prostate cancer screening discussions starting at age 50, or 45 for high-risk men, with PSA tests and digital rectal exams 1
- Regular testicular self-exams, skin checks for abnormal moles, and eye exams every 2-4 years
- Depression screening during routine healthcare visits
- Appropriate vaccinations, including annual flu shots, Tdap every 10 years, and shingles vaccine after age 50 These screenings are essential because many serious conditions like hypertension, high cholesterol, and early-stage cancers often have no symptoms, and early detection significantly improves treatment outcomes and reduces mortality rates 1. Key considerations for prostate cancer screening include:
- The benefits and risks of screening, including the potential for false-positive results and overtreatment
- Individual risk factors, such as family history and African American race
- The importance of informed and shared decision-making between patients and healthcare providers
- The use of patient decision aids to support informed decision-making 1. By prioritizing these screenings and engaging in informed decision-making, men can take a proactive approach to maintaining their health and reducing their risk of morbidity and mortality.
From the Research
Recommended Health Screenings for Men
The following are recommended health screenings for men:
- Prostate-specific antigen (PSA) testing: PSA testing is a common screening method for prostate cancer, and its effectiveness has been studied in various research papers 2, 3, 4, 5.
- Digital rectal examination (DRE): DRE is another screening method for prostate cancer, although its diagnostic value has been questioned in recent studies 6, 5.
- Transrectal ultrasonography (TRUS): TRUS is a more costly screening method that may not add appreciable detectability when results of both DRE and PSA determination are normal 2.
Screening Modalities
Different screening modalities have been compared in various studies:
- DRE + TRUS vs. PSA: A study found that both screening modalities achieved comparable results in terms of early detection, but screening by PSA had a higher compliance and lower costs 4.
- PSA alone vs. combination of DRE and PSA: A meta-analysis found that the screening strategy combining DRE and PSA was not different from that of PSA alone in terms of cancer detection rate (CDR) and positive predictive value (PPV) 5.
Diagnostic Value of DRE
The diagnostic value of DRE as a screening test for prostate cancer has been assessed in several studies:
- A systematic review and meta-analysis found that DRE exhibits a notably low diagnostic value, and its use as a supplementary measure to PSA for prostate cancer detection may not be necessary 5.
- Another study found that the absence of definitive data or explicit guidelines regarding the use of DRE for prostate cancer screening may lead to confusion for physicians and patients alike 3.