What health screenings are recommended for a 23-year-old male?

Health Screenings for a 23-Year-Old Male

At age 23, routine cancer screenings are not recommended, but this is an important time for establishing baseline health metrics, lifestyle counseling, and addressing sexual health. 1, 2

Core Health Assessments

Vital Signs and Basic Measurements

• Blood pressure screening should be performed at every clinical visit, as cardiovascular risk assessment begins in young adulthood 2, 3
• Height and weight measurements to calculate BMI are essential to identify obesity early and provide appropriate counseling 3

Laboratory Screening

• Lipid screening is NOT routinely recommended at age 23 unless specific risk factors are present (family history of premature cardiovascular disease, diabetes, hypertension, or BMI ≥25 kg/m²) 2, 3
• Diabetes screening with hemoglobin A1C should be performed if BMI ≥25 kg/m² with additional risk factors including first-degree relative with diabetes, high-risk race/ethnicity, hypertension, HDL <35 mg/dL, or triglycerides >250 mg/dL 2
• Complete blood count and comprehensive metabolic panel are not routinely indicated at this age without specific clinical indications 2

Cancer Screening

What NOT to Screen For

• Prostate cancer screening is NOT recommended at age 23 - PSA testing discussions should not begin until age 45-50 for average-risk men, or age 40-45 for high-risk men (African American or strong family history) 4, 1, 2
• Colorectal cancer screening is NOT recommended until age 45 1, 2, 3
• Lung cancer screening is NOT indicated unless there is a 30-pack-year smoking history (not applicable at age 23) 3

Testicular Examination

• Testicular examination should be performed as part of the cancer-related checkup, though evidence for routine screening by physician or self-examination is insufficient 4

Essential Health Counseling

Sexual Health

• Sexual history documentation and STI screening are critically important at this age but are frequently neglected in practice 5
• Screen for HIV and sexually transmitted infections (gonorrhea/chlamydia) based on sexual activity and risk factors including multiple partners, men who have sex with men, or inconsistent condom use 3, 5

Lifestyle Risk Assessment

• Tobacco use screening and cessation counseling should be performed at every visit 3
• Alcohol use assessment using validated screening tools 3
• Diet and exercise habits should be reviewed with specific counseling on healthy lifestyle choices 1, 3
• Discussion of safe sexual practices and contraception as appropriate 3

Immunizations

• Update immunizations according to Advisory Committee on Immunization Practices (ACIP) guidelines, which at age 23 typically includes ensuring completion of HPV vaccine series (if not previously completed), meningococcal vaccine, and annual influenza vaccine 3

Common Pitfalls to Avoid

• Do not order PSA testing at this age - it provides no benefit and leads to unnecessary anxiety and procedures 4
• Do not skip sexual health screening - this is one of the most under-documented yet critical assessments for this age group, with only 21% of adolescent/young adult visits documenting sexual history 5
• Do not perform routine comprehensive metabolic panels or CBCs without clinical indication, as this leads to false positives and unnecessary follow-up 2