Screenings worth keeping on schedule

Most of what matters is unglamorous and quick.

  • Blood pressure — at least every one to two years, more often if elevated.
  • Lipid panel — periodically from young adulthood, with intervals set by risk. Ask for non-HDL cholesterol alongside LDL.
  • Glucose or A1C — from around age 35 with overweight or obesity, earlier with other risk factors.
  • Colorectal cancer — from 45 for average risk, by colonoscopy or stool-based testing.
  • Lung cancer — annual low-dose CT for eligible adults with a significant smoking history.
  • Abdominal aortic aneurysm — a one-time ultrasound for men 65 to 75 who have ever smoked.
  • Hepatitis C and HIV — at least once for adults, with repeat testing by risk.
  • Depression screening — recommended for adults, and often the only time it comes up.

Ask directly what is due now and what is due next year, rather than waiting to be offered.

The prostate conversation

PSA screening is framed as a shared decision rather than a routine recommendation, because benefits and harms are closely balanced.

The potential benefit is detecting aggressive prostate cancer earlier, which can reduce prostate cancer deaths in screened populations, though the absolute effect is modest.

The potential harms are substantial: PSA can be raised by benign enlargement and infection, leading to biopsies with their own risks, and screening detects cancers that would never have caused symptoms — overdiagnosis — which can lead to treatment with urinary and sexual side effects.

  • Discuss from around 55 to 69, and earlier for Black men and those with a family history.
  • Ask what happens next if the result is raised.
  • Ask about active surveillance, now standard for many low-risk cancers.
  • Deciding not to test is a legitimate, evidence-consistent choice.

Cardiovascular risk in men

Men develop clinically apparent coronary artery disease around a decade earlier than women on average, so risk assessment matters earlier and symptoms in men in their forties and fifties should not be dismissed as too young.

The modifiable factors are the familiar list: smoking, blood pressure, lipids, diabetes, abdominal obesity, inactivity, excess alcohol, and untreated sleep apnea. They multiply rather than simply add, so improving several modestly often achieves more than perfecting one.

  • Learn heart attack and stroke warning signs, and commit to calling early.
  • Chest discomfort that appears reliably with exertion warrants prompt assessment.
  • New erectile difficulty can be an early marker of vascular disease, since penile arteries are smaller than coronary arteries.
  • Address snoring and daytime sleepiness rather than tolerating them.

Mental health that goes unspoken

Men are diagnosed and treated for depression less often than women but die by suicide at higher rates in most countries. Part of the gap is how symptoms present.

  • Irritability and anger rather than visible sadness.
  • Withdrawal from friends, hobbies, and family while appearing functional at work.
  • Increased alcohol or substance use, often described as unwinding.
  • Physical symptoms — headaches, digestive problems, back pain, fatigue without clear cause.
  • Risk-taking or overwork that is out of character.

Effective treatment exists, and structured therapies such as cognitive behavioural therapy are practical and time-limited. Seek urgent help for thoughts of harming yourself or others — in the US, call or text 988. Asking someone directly about suicidal thoughts does not increase risk.