What health screening tests are recommended for a 47-year-old male with no specified health issues?

Health Screening Recommendations for a 47-Year-Old Male

For a 47-year-old average-risk male, initiate colorectal cancer screening at age 50 with colonoscopy every 10 years or annual fecal immunochemical testing (FIT), screen blood pressure at every visit, check lipid panel now and every 5 years if normal, and engage in shared decision-making about prostate cancer screening starting at age 50-55 (not routinely at age 47). 1, 2, 3

Colorectal Cancer Screening

Begin screening discussions now in preparation for age 50:

• Standard recommendation: Start colorectal cancer screening at age 50 for average-risk individuals 1, 2, 3
• First-tier options include colonoscopy every 10 years or annual FIT 2
• Alternative options: CT colonography every 5 years, flexible sigmoidoscopy every 5 years, or multitarget stool DNA test every 3 years 1
• Earlier screening (age 45) is recommended only for African American men or those with a first-degree relative diagnosed before age 65 2

Critical pitfall: Never perform single-panel guaiac FOBT during digital rectal examination due to low sensitivity 2

Prostate Cancer Screening

Do not routinely screen at age 47:

• Screening is not recommended as routine practice for men aged 40-54 at average risk 1
• The evidence shows marginal benefit at best in this age group, with harms equal to or exceeding benefits 1
• Begin shared decision-making discussions at age 50-55 for average-risk men 1
• The US Preventive Services Task Force recommends informed decision-making for men aged 55-69 years 1
• Earlier discussion (age 45) is appropriate only for high-risk men (African American or first-degree relative with prostate cancer diagnosed before age 65) 1

Key consideration: PSA screening requires at least 10-15 year life expectancy to potentially benefit 1

Cardiovascular Risk Assessment

Screen lipids now:

• Check total cholesterol and HDL for men aged 40-75 years 2, 3
• Repeat every 5 years if normal, more frequently if borderline 2
• Blood pressure screening should be performed at every clinical encounter 2, 3
• Calculate body mass index at each visit using height and weight 3

Lung Cancer Screening

Not indicated at age 47 unless heavy smoking history:

• Screening is recommended only for ages 55-80 years with ≥30 pack-year smoking history who currently smoke or quit within past 15 years 1, 3
• Use low-dose CT annually if criteria met 1, 3

Abdominal Aortic Aneurysm Screening

Not indicated at age 47:

• One-time screening ultrasonography is recommended only for men aged 65-75 years who have ever smoked 3

Immunizations

Update according to Advisory Committee on Immunization Practices guidelines:

• Ensure tetanus-diphtheria is current 3, 4
• Review and update all age-appropriate vaccinations 3

Lifestyle Counseling

Address key behavioral risk factors:

• Tobacco use: Provide cessation counseling if applicable 3
• Alcohol use: Screen and counsel on safe limits 3
• Diet and exercise: Provide evidence-based guidance 3, 4
• Sexual health: Assess risk for sexually transmitted infections including HIV 3