From the Guidelines
For a 63-year-old male's annual wellness visit, I recommend the following laboratory tests: complete blood count (CBC), comprehensive metabolic panel (CMP), lipid panel, hemoglobin A1C, thyroid stimulating hormone (TSH), urinalysis, and PSA (prostate-specific antigen) screening, as supported by the American Cancer Society guidelines 1 and updated guidelines on cancer screening 1.
Recommended Laboratory Tests
- Complete blood count (CBC) to evaluate for anemia and infection
- Comprehensive metabolic panel (CMP) to assess electrolytes and organ function
- Lipid panel to evaluate cardiovascular risk
- Hemoglobin A1C to monitor for diabetes or prediabetes
- Thyroid stimulating hormone (TSH) to screen for thyroid disorders
- Urinalysis to assess kidney function and detect potential urinary tract issues
- PSA (prostate-specific antigen) screening, with a discussion of the benefits and limitations of prostate cancer screening, as recommended by the American Cancer Society 1 and updated guidelines on cancer screening 1
Additional Tests to Consider
- Vitamin D level, especially if the patient has risk factors for deficiency
- Hepatitis C screening, if born between 1945-1965 and not previously tested
- Colon cancer screening, such as FIT or colonoscopy, if not done within recommended intervals, as recommended by the American Cancer Society 1 and updated guidelines on cancer screening 1 These tests provide a comprehensive assessment of overall health status, including kidney and liver function, blood sugar control, cholesterol levels, and prostate health. The CBC, CMP, and lipid panel help evaluate cardiovascular risk, while A1C monitors for diabetes or prediabetes. TSH screens for thyroid disorders, which become more common with age. PSA testing should be discussed with the patient, weighing the benefits and limitations of prostate cancer screening, as recommended by the American Cancer Society 1 and updated guidelines on cancer screening 1.
Cancer Screening
- Colon cancer screening, such as FIT or colonoscopy, is recommended for men and women aged 50 and older, as supported by the American Cancer Society guidelines 1 and updated guidelines on cancer screening 1
- Prostate cancer screening should be discussed with the patient, weighing the benefits and limitations of screening, as recommended by the American Cancer Society 1 and updated guidelines on cancer screening 1
From the Research
Recommended Laboratory Tests
The following laboratory tests are recommended for a 63-year-old male during an annual wellness visit:
- Prostate-specific antigen (PSA) testing may be considered, but shared decision-making is strongly recommended due to potential harms related to false-positive test results, unnecessary biopsies, overdiagnosis, and overtreatment 2
- Lipid screening is warranted in all men 35 years and older 3
- Screening for diabetes mellitus is recommended for men with sustained blood pressures greater than 135/80 mm Hg 3
- Ultrasound screening for abdominal aortic aneurysm should occur between 65 and 75 years of age in men who have ever smoked 3
- Colorectal cancer screening should begin at 50 years of age in men of average risk and continue until at least 75 years of age 3
- Complete blood count (CBC) and urinalysis may be considered as part of an annual physical examination, although evidence for their routine use is limited 4
Considerations for Laboratory Tests
When determining whether to perform laboratory tests, the following factors should be considered:
- Metabolic syndrome (MS) may be associated with decreased PSA levels, and should be taken into account when interpreting PSA test results 5
- The patient's medical history, including substance use, risk factors for sexually transmitted infections, diet and exercise habits, and symptoms of depression, should be considered when determining which laboratory tests to order 3
- The patient's cardiovascular risk factors, such as blood pressure and lipid levels, should be taken into account when determining the frequency of laboratory tests 3