Prevention Guidelines for Men 40 to 49

May 05, 2019

Prevention Guidelines for Men 40 to 49

Here are the screening tests and immunizations that most men ages 40 to 49 need. A screening test is done to find possible disorders or diseases in people who don't have any symptoms. The goal is to find a disease early so lifestyle changes can be made and you can be watched more closely to reduce the risk of disease, or to detect it early enough to treat it most effectively. Screening tests are not considered diagnostic, but are used to determine if more testing is needed. Although you and your healthcare provider may decide that a different schedule is best for you, this plan can guide your discussion.

Screening

Who needs it

How often

Alcohol misuse

All adults

At routine exams

Blood pressure

All adults

Yearly checkup if your blood pressure is normal*

Normal blood pressure is less than 120/80 mm Hg*

If your blood pressure reading is higher than normal, follow the advice of your healthcare provider

Depression

All men in this age group

At routine exams

Type 2 diabetes or prediabetes

All men beginning at age 45 and men without symptoms at any age who are overweight or obese and have 1 or more additional risk factors for diabetes

At least every 3 years (annually if blood sugar is already rising)

Type 2 diabetes

All men with prediabetes

Every year

BMI (body mass index)

All men in this age group

Every year, to help find out if you are at a healthy weight for your height

Hepatitis C

Anyone at increased risk

At routine exams

HIV

All men

At routine exams

High cholesterol and triglycerides

All men ages 35 and older, and younger men at high risk for coronary artery disease

At least every 5 years

Obesity

All adults

At routine exams

Prostate cancer

Starting at age 45, talk to healthcare provider about risks and benefits of digital rectal exam (DRE) and prostate-specific antigen (PSA) screening***

At routine exams

Colorectal cancer

Men of average risk ages 45 and older

Several tests are available and used at different times.

Tests include:

  • Flexible sigmoidoscopy every 5 years, or

  • CT colonography (virtual colonoscopy) every 5 years, or

  • Colonoscopy every 10 years, or

  • Yearly fecal occult blood test, or

  • Yearly fecal immunochemical test every year, or

  • Stool DNA test, every 3 years

You will need a follow-up colonoscopy if you choose any test other than a colonoscopy and you have an abnormal result. Screening recommendations vary among expert groups. Talk with your doctor about which test is best for you.

Some people should be screened using a different schedule because of their personal or family history. Talk with your doctor about your health history and what colorectal cancer screening schedule is best for you.

Syphilis

Anyone at increased risk for infection

At routine exams

Tuberculosis

Anyone at increased risk for infection

Check with your healthcare provider

Vision

All adults (1)

Every 2 to 4 years if no risk factors for eye disease (2); ask your healthcare provider if you need glaucoma screening with a dilated eye exam after 2 years

Counseling

Who needs it

How often

Diet and exercise,

Adults who are overweight or obese

When diagnosed and at routine exams

Aspirin for primary prevention of cardiovascular problems

Men ages 45 to 79, when potential benefits from a decrease in heart attacks outweigh the harm or risks from an increase in gastrointestinal hemorrhage

When diagnosed with risk for cardiovascular/heart disease; check with your healthcare provider before starting

Sexually transmitted infection prevention

Anyone at increased risk for infection

At routine exams

Tobacco use and tobacco-related disease

All adults

Every exam

Immunization

Who needs it

How often

Tetanus/diphtheria/
pertussis (Td/Tdap) booster

All adults

Td: every 10 years

Tdap: substitute a 1-time dose of Tdap for a Td booster after age 18, then boost with Td every 10 years

Measles, mumps, rubella (MMR)

All adults in this age group who have no record of previous infection or vaccines**

1 or 2 doses

Chickenpox (varicella)

All adults in this age group who have no record of previous infection or vaccines**

2 doses; the second dose should be given at least 4 weeks after the first dose

Flu (seasonal)

All adults

Yearly, when the vaccine becomes available in the community

Hepatitis A

Men at risk (2)

2 or 3 doses (depending on the vaccine) given at least 6 months apart; check with your healthcare provider

Hepatitis B

Men at risk (3)

2 or 3 doses (depending on the vaccine) over 6 months; check with your healthcare provider. The second dose should be given 1 month after the first dose, and the third dose should be given at least 2 months after the second dose and at least 4 months after the first dose

Haemophilus influenza Type B (HIB)

Men at risk

1 to 3 doses

Meningococcal ACWY (MenACWY)

Men at risk**

1 or more doses, depending on your case; then a booster every 5 years if you are still at risk; check with your healthcare provider

Meningococcal B (MenB)

Men at risk

2 or 3 doses, depending on the vaccine and your case; check with your healthcare provider

Pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23)

Men at risk4

PCV13: 1 dose ages 19 to 65 (protects against 13 types of pneumococcal bacteria)

 

PPSV23: 1 to 2 doses through age 64, or 1 dose at 65 or older (protects against 23 types of pneumococcal bacteria)

 

*Recommendation from the American College of Cardiology and the American Heart Association Task Force on Clinical Practice Guidelines

**Exceptions may exist; discuss with your healthcare provider

***National Comprehensive Cancer Network

1Recommendation from the American Academy of Ophthalmology

2For complete list, see the CDC website

3For complete list, see the CDC website

4For complete list, see the CDC website

Screening guidelines from the U.S. Preventive Services Task Force

Immunization schedule from the CDC

Updated:  

May 05, 2019

Sources:  

Evidence-based approach to prevention, Up To Date, Overview of Hypertension in Adults, Up To Date, Standards of Medical Care in Diabetes, 2016, American Diabetes Association

Reviewed By:  

Pierce-Smith, Daphne, RN, MSN, CCRC,Watson, L Renee, MSN, RN