Tests that should be done by men over 40

International Men's Health Month is marked in June, encouraging men all over the globe to promote their health and check for signs and symptoms of health problems that can be addressed before they become serious.

Regular health exams are required for both men and women after a certain age, and Dr Niti Raizada, director, medical oncology and hemato oncology at Fortis Group of Hospitals, Richmond Road Bangalore, believes that men over the age of 40 should take a different approach to their health.

Going for testing, such as a routine blood pressure check, is part of this. "More than 80% of persons with hypertension have no symptoms, and the only way to find out is to do an evaluation." "A cardiac evaluation would include cholesterol levels, and if there is an imbalance, it must be rectified before atheromatous plaques in the blood arteries of the heart, brain, limbs, and other organs develop," the doctor continues.

She goes on to say that a treadmill stress test is recommended to determine physical endurance, which is important for lifespan as well as any indication of approaching myocardial ischemia. "However, because this test's sensitivity is around 70%, more advanced procedures such as cardiac CT examination are indicated."

The next step would be to assess the pre-diabetic condition. "This will assist evaluate if the person is on the path to metabolic syndrome, and course correction in lifestyle will need to be implemented right now to avoid future illnesses," Dr. Raizada explains.

As per her, the next round of tests will focus on cancer. Prostate cancer is at the top of the list, and the baseline test is serum PSA. Lung cancer is diagnosed with a chest X-ray, colorectal cancer is diagnosed with a yearly stool screening for occult blood and sigmoidoscopy/colonoscopy every 3-5 years, if needed. "An ultrasound examination of the scrotum is used to screen for testicular cancer. Genetic testing for inherited illnesses and cancers is now available, and a person only needs to go through it once to assess their risks."

Tests for osteoporosis, or bone thinning, should also be done, she says, noting that vitamin D is necessary for calcium absorption and deposition in the bones, and that if levels have declined, this must be addressed.

The doctor discusses hormone testing, but not just thyroid hormone testing. "Testosterone should be included for hypogonadism, which affects approximately a third of men over the age of 40." For haemoglobin quality, check vitamin B12 levels and serum ferritin levels. Physical exertion will be possible without feeling out of breath if haemoglobin levels are normal."

There are more tests to run:

• Testing for sexually transmitted illnesses such as HIV, syphilis, and chlamydia, as well as disorders such as Hepatitis C and B.
• Tuberculosis, which is frequent in immunocompromised people, is ruled out.
• The necessary testing includes viral markers for Covid and its impacts (long Covid).
• Ophthalmic evaluation, as well as a dental checkup and dental hygiene. An immunisation plan for annual flu injections, pneumococcal pneumonia prevention, Covid booster, diphtheria tetanus, and herpes zoster/shingles will be discussed during the preventive assessment.
• Obesity: For men aged 40 and up, a suitable diet/nutrition plan is required as key component of the evaluation.