Health Maintenance Guidelines

Co-workers Health Maintenance Guidelines
Section 1 – General Health Screening
URL of this page: http://www.nlm.nih.gov/medlineplus/ency/article/007465.htm
Health screening – men – ages 40 to 64
You should visit your health care provider regularly, even if you feel healthy. The
purpose of these visits is to:
1. Screen for medical issues
2. Assess your risk of future medical problems
3. Encourage a healthy lifestyle
4. Update vaccinations
5. Help you get to know your provider in case of an illness
6. Information
Even if you feel fine, you should still see your health care 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. Simple
blood tests can check for these conditions.
There are specific times when you should see your provider. Below are screening
guidelines for men ages 40 – 64.
BLOOD PRESSURE SCREENING
1. Have your blood pressure checked every 2 years. If the top number (systolic
number) is between 120 – 139 or the bottom number (diastolic number) is
between 80 – 89 mm Hg then have it checked every year.
2. Watch for blood pressure screenings in your area. Ask your provider if you can
stop in to have your blood pressure checked. Or check your blood pressure using
the automated machines at local grocery stores and pharmacies.
3. If the top number is greater than 140 or the bottom number is greater than 90,
schedule an appointment with your provider.
4. If you have diabetes, heart disease, kidney problems, or certain other conditions,
you may need to have your blood pressure checked more often.
CHOLESTEROL SCREENING AND HEART DISEASE PREVENTION
1. If you are over age 34, you should be checked every 5 years.
2. If you have high cholesterol levels, diabetes, heart disease, kidney problems, or
certain other conditions, you may need to be checked more often.
3. Some men should consider taking aspirin to prevent heart attacks. Ask your
provider before you start aspirin because aspirin can increase your risk for
bleeding.
DIABETES SCREENING
1. If you are over age 45, you should be screened every 3 years.
2. If you are overweight, ask your provider if you should be screened at a younger
COLON CANCER SCREENING
If you are under age 50, you should be screened only if you have a strong family
history of colon cancer or polyps, or if you have had inflammatory bowel disease
or polyps.
If you are between ages 50 – 75, you should be screened for colorectal cancer.
This may involve:
1. A stool test done every year
2. Flexible sigmoidoscopy every 5 – 10 years along with a stool guaiac test
3. Colonoscopy every 10 years
4. You may need a colonoscopy more often if you have risk factors for colon
cancer, such as:
Ulcerative colitis
A personal or family history of colorectal cancer
A history of large colorectal adenomas
DENTAL EXAM
Go to the dentist every year for an exam and cleaning.
Have an eye exam every 1 – 3 years if you have vision problems or glaucoma risk.
IMMUNIZATIONS
1. You should get a flu shot every year.
2. Your doctor may recommend other vaccinations if you have certain medical
conditions, such as diabetes.
3. You should have a tetanus-diphtheria booster vaccination every 10 years. If you
have not received a tetanus-diphtheria and acellular pertussis (Tdap) vaccine as
one of your tetanus-diphtheria vaccines, you should have it once.
4. You may get a shingles or herpes zoster vaccination once after age 60.
OSTEOPOROSIS SCREENING
If you are between ages 50 – 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, or a family history of osteoporosis.
PHYSICAL EXAM
You should have a preventive health visit every 2 years until age 50, and then
once a year.
Routine diagnostic tests are not recommended.
Your height, weight, and body mass index (BMI) should be checked at every
exam.
During your exam, your provider may ask you about:
Depression
Diet and exercise
Alcohol and tobacco use
Safety, such as use of seat belts and smoke detectors
PROSTATE CANCER SCREENING
1. Most men age 50 or older should discuss screening for prostate cancer with their
provider. African American men and those with a family history of prostate cancer
should discuss screening at age 45.
2. The potential benefits of PSA testing have not been shown to outweigh the
harms of testing and treatment. If you choose to be tested, the PSA blood test is
most often done every year.
3. Prostate examinations are no longer routinely done on men with no symptoms.
TESTICULAR EXAM
The U.S. Preventive Services Task Force (USPSTF) now recommends against
performing testicular self-exams. Doing testicular self-exams has no benefit.
LUNG CANCER SCREENING
The USPSTF recommends annual screening for lung cancer with low-dose
computed tomography (LDCT) in adults aged 55 – 80 years who:
Have a 30 pack-year smoking history AND
Currently smoke or have quit within the past 15 years
Alternative Names
Health maintenance visit – men – ages 40 – 64; Physical exam – men – ages 40 –
64; Yearly exam – men – ages 40 – 64; Checkup – men – ages 40 – 64; Men’s
health – ages 40 – 64; Preventive care – men – ages 40 – 64
References
American Diabetes Association. Standards of medical care in diabetes — 2014.
Diabetes Care. 2014;37 Suppl 1:S14-S80.
Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds.
Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 14.
Centers for Disease Control and Prevention. Recommended Immunization Schedule for
Adults, United States, 2014. Available at http://www.cdc.gov/vaccines/schedules/
downloads/adult/adult-schedule.pdf. Accessed July 24, 2014.
Gaziano M, Ridker PM, Libby P. Primary and secondary prevention of coronary heart
disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald’s Heart Disease:
A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders; 2012:1010.
Handler J, et al. 2014 evidence-based guideline for the management of high blood
pressure in adults: report from the panel members appointed to the Eighth Joint
National Committee (JNC 8). JAMA. 2014 Feb 5;311(5):507-520.
Helfand M, Carson S. Screening for Lipid Disorders in Adults: Selective Update of 2001
US Preventive Services Task Force Review. Rockville (MD): Agency for Healthcare
Research and Quality (US); 2008 Jun.
Levin B, Lieberman DA, McFarland B, Smith RA, Brooks D, Andrews KS, et al.
Screening and surveillance for the early detection of colorectal cancer and
adenomatous polyps, 2008: A joint guideline from the American Cancer Society, the
U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of
Radiology. CA Cancer J Clin. 2008;58:130-160.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in
Oncology (NCCN Guidelines): Colorectal cancer screening. Version 2.2013. Available at
http://www.nccn.org/professionals/physician_gls/pdf/colorectal_screening.pdf. Accessed
July 24, 2014.
National Osteoporosis Foundation. Clinician’s Guide to Prevention and Treatment of
Osteoporosis. Washington, DC: National Osteoporosis Foundation; 2013.
Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension:
what are the right goals and purposes? JAMA. 2014 Feb 5;311(5):474-476.
Rex DK, Johnson DA, Anderson JC, Schoenfeld PS, Burke CA, Inadomi JM; American
College of Gastroenterology. American College of Gastroenterology guidelines for
colorectal cancer screening 2009 [corrected]. Am J Gastroenterol. 2009;104:739-750.
Screening for Prostate Cancer. U.S. Preventive Services Task Force web site. Available
at http://www.uspreventiveservicestaskforce.org/prostatecancerscreening.htm.
Accessed July 24, 2014.
Smith RA, Cokkinides V, Brooks D, Saslow D, Brawley OW. Cancer screening in the
United States, 2010. A review of current American Cancer Society guidelines and issues
in cancer screening. CA Cancer J Clin. 2010; 60(2):99-119.
Stone NJ, Robinson J, Lichtenstein AH, Bairey Merz N, Blum CB, et al. 2013 ACC/AHA
Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic
Cardiovascular Risk in Adults. Circulation. 2014 Jun 24;129(25 Suppl 2):S1-S45.
U.S. Preventive Services Task Force. Screening for osteoporosis: recommendation
statement. Am Fam Physician. 2011;83:1197-1200.
Whitlock EP, Lin J, Liles E, Beil T, Fu R, O’Connor E, Thompson RN, Cardenas T.
Screening for Colorectal Cancer: An Updated Systematic Review [Internet]. Rockville
(MD): Agency for Healthcare Research and Quality (US); 2008 Oct.
http://www.ncbi.nlm.nih.gov/books/NBK35179/. Accessed July, 24, 2014.
Update Date: 8/8/2014
Health screening – men age 65 and older
You should visit your health care provider regularly, even if you feel healthy. The
purpose of these visits is to:
1. Screen for medical issues
2. Assess your risk of future medical problems
3. Encourage a healthy lifestyle
4. Update vaccinations
5. Help you get to know your provider in case of an illness
6. Information
Even if you feel fine, you should still see your health care 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. Below are screening
guidelines for men age 65 and older.
ABDOMINAL AORTIC ANEURYSM SCREENING
If you are between ages 65 – 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 every year.
If you have diabetes, heart disease, kidney problems, or certain other conditions, you
may need to be checked more often.
CHOLESTEROL SCREENING AND HEART DISEASE PREVENTION
Your cholesterol should be checked every 5 years if levels are normal.
If you have high cholesterol, diabetes, heart disease, kidney problems, or certain other
conditions, you may need to be checked more often.
LUNG CANCER SCREENING
The U.S. Preventive Services Task Force recommends annual screening for lung
cancer with low-dose computed tomography (LDCT) in adults until age 80 who:
Have a 30 pack-year smoking history AND
Currently smoke or have quit within the past 15 years
COLON CANCER SCREENING
Until age 75, you should have one of the following screening tests:
A stool test done every year
Flexible sigmoidoscopy every 5 – 10 years, along with a stool guaiac test
Colonoscopy every 10 years
You may need a colonoscopy more often if you have risk factors for colon cancer, such
Ulcerative colitis
A personal or family history of cancer of the colon or rectum
A history of large growths called adenomas
DIABETES SCREENING
If you are age 65 or older and in good health, you should be screened for diabetes
every 3 years.
If you are overweight and have other risk factors for diabetes, ask your doctor if you
should be screened more often.
DENTAL EXAM
Go to the dentist every year for an exam and cleaning.
Have an eye exam every 1 – 2 years if you have vision problems or glaucoma risk.
HEARING TEST
Have your hearing tested if you have symptoms of hearing loss.
IMMUNIZATIONS
If you are age 65 or older, get a pneumococcal vaccine if you have never had one, or if
it has been more than 5 years since you had the vaccine.
You should get a flu shot each year.
Get a tetanus-diphtheria booster every 10 years.
You may get a shingles or herpes zoster vaccine after age 60.
OSTEOPOROSIS SCREENING
If you have risk factors for osteoporosis, you should check with your provider about
screening. Risk factors can include long-term steroid use, low body weight, smoking,
heavy alcohol use, or a family history of osteoporosis.
PROSTATE CANCER SCREENING
Talk to your provider about prostate cancer screening. The potential benefits of PSA
testing have not been shown to outweigh the harms of testing and treatment.
If screening is done, a PSA test is the best method.
Routine prostate exam for men without symptoms is not recommended.
PHYSICAL EXAMS
Have a yearly physical exam.
Your provider will check your weight, height, and body mass index (BMI).
During the exam, your provider will ask you questions about:
Your medicines and risk of interactions
Alcohol and tobacco use
Diet and exercise
Safety, such as using a seat belt, or smoke alarms
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
American Diabetes Association. Standards of medical care in diabetes — 2014.
Diabetes Care. 2014;37 Suppl 1:S14-S80.
Atkins D, Barton M. The periodic health examination. In: Goldman L, Schafer AI, eds.
Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 14.
Basch E, Oliver TK, Vickers A, et al. Screening for prostate cancer with prostate-specific
antigen testing: American Society of Clinical Oncology provisional clinical opinion. J Clin
Oncol. 2012 Aug 20;30(24):3020-5.
Centers for Disease Control and Prevention. Recommended Immunization Schedule for
Adults, United States, 2014. http://www.cdc.gov/vaccines/schedules/downloads/adult/
adult-schedule.pdf. Accessed July 24, 2014.
Gaziano M, Ridker PM, Libby P. Primary and secondary prevention of coronary heart
disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald’s Heart Disease:
A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders; 2012:1010.
Greenland P, Alpert JS, Beller GA, et al. 2010 ACCF/AHA guideline for assessment of
cardiovascular risk in asymptomatic adults: a report of the American College of
Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.
Circulation. 2010;122(25):e584-e636.
Handler J, et al. 2014 evidence-based guideline for the management of high blood
pressure in adults: report from the panel members appointed to the Eighth Joint
National Committee (JNC 8). JAMA. 2014 Feb 5;311(5):507-520.
Helfand M, Carson S. Screening for Lipid Disorders in Adults: Selective Update of 2001
US Preventive Services Task Force Review. Rockville, MD: Agency for Healthcare
Research and Quality (US); 2008 Jun.
Levin B, Lieberman DA, McFarland B, Smith RA, Brooks D, Andrews KS, et al.
Screening and surveillance for the early detection of colorectal cancer and
adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the
U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of
Radiology. CA Cancer J Clin. 2008;58:130-160.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in
Oncology (NCCN Guidelines): Colorectal cancer screening. Version 2.2013. Available at
http://www.nccn.org/professionals/physician_gls/pdf/colorectal_screening.pdf. Accessed
July 24, 2014.
National Osteoporosis Foundation. Clinician’s Guide to Prevention and Treatment of
Osteoporosis. Washington, DC: National Osteoporosis Foundation; 2013.
Peterson ED, Gaziano JM, Greenland P. Recommendations for treating hypertension:
what are the right goals and purposes? JAMA. 2014 Feb 5;311(5):474-476.
Rex DK, Johnson DA, Anderson JC, Schoenfeld PS, Burke CA, Inadomi JM; American
College of Gastroenterology. American College of Gastroenterology guidelines for
colorectal cancer screening 2009 [corrected]. Am J Gastroenterol. 2009;104:739-750.
Screening for Prostate Cancer. U.S. Preventive Services Task Force Web site. http://
www.uspreventiveservicestaskforce.org/prostatecancerscreening.htm. Accessed July
Stone NJ, Robinson J, Lichtenstein AH, Bairey Merz N, Blum CB, et al. 2013 ACC/AHA
Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic
Cardiovascular Risk in Adults. Circulation. 2014 Jun 24;129(25 Suppl 2):S1-S45.
U.S. Preventive Services Task Force. Recommendations for adults. Rockville, MD:
Agency for Healthcare Research and Quality; 2013. Accessed July 24, 2014.
U.S. Preventive Services Task Force. Screening for osteoporosis: recommendation
statement. Am Fam Physician. 2011;83:1197-1200.
Whitlock EP, Lin J, Liles E, Beil T, Fu R, O’Connor E, Thompson RN, Cardenas T.
Screening for Colorectal Cancer: An Updated Systematic Review [Internet]. Rockville,
MD: Agency for Healthcare Research and Quality (US); 2008 Oct.
http://www.ncbi.nlm.nih.gov/books/NBK35179/. Accessed July, 24, 2014.
Wolf AM, Wender RC, Etzioni RB, et al. American Cancer Society guideline for the early
detection of prostate cancer: update 2010. CA Cancer J Clin. 2010;60:70-98.
Update Date: 8/8/2014
Topics to be covered in future sections include:
Co-workers Health Maintenance Guidelines Categories
1. General Health Screening
2. Nutrition and Vitamin Supplementation
3. Physical Activity and Exercise
4. Immunization and Preventative Care for Travelers
5. Sleep and Sleep Hygiene
6. Weight loss and Weight Maintenance
7. Prescription Medications and Supplements (Herbals)
8. Travel Habits: Airplanes, Meals, and Sleep
9. Avoiding Unnecessary Risk, Injury Prevention, and Emergency Preparedness when
Traveling
10.Medical Insurance and Travel Insurance