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Men’s preventive health screenings essential for readiness and a lifetime of good health

Hospitalman Payton Dupuis, a native of Mill City, Oregon, checks veteran Joseph Levette’s blood pressure at Naval Hospital Jacksonville’s internal medicine clinic. “Men’s health is a vital part of the mission,” stated Dupuis. “We need a healthy workforce to succeed.” (U.S. Navy photo by Jacob Sippel) Hospitalman Payton Dupuis, a native of Mill City, Oregon, checks veteran Joseph Levette’s blood pressure at Naval Hospital Jacksonville’s internal medicine clinic. “Men’s health is a vital part of the mission,” stated Dupuis. “We need a healthy workforce to succeed.” (U.S. Navy photo by Jacob Sippel)

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Physicians can provide checklists that inform male patients of important health screenings for their 40s, 50s, and beyond. These checklists make for a good start, but age is only one factor physicians consider.

According to Col. John Barrett, the Army senior service leader and associate professor at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, primary care providers review literature around a variety of conditions and apply evidence-based protocols specific to each patient.

“Their recommendations are based on patient health status, symptoms, and risk factors,” explained Barrett.

Health care providers consult the U.S. Preventive Services Task Force, or USPSTF, an independent panel of volunteer experts in disease prevention and evidence-based medicine. “The USPSTF serves as the standard for clinical preventive services recommendations,” said Barrett. “This group is at the forefront of recommending evidence-based screenings that encompass conditions and risk factors for those conditions.” Medical societies, such as the American Academy of Family Physicians, generally follow USPSTF guidelines, and the Military Health System is one of many federal partners.

Barrett used USPSTF guidelines to create a chart with case studies of adult male patients in different life stages. Said Barrett, “The chart’s three subjects are a 24-year-old active duty soldier, a 44-year-old military retiree, and a 66-year-old contemplating retirement from his post-military career. The chart should raise men’s awareness of their own health conditions and screenings that their primary care physician might suggest.”

One of the recommended screenings is a colorectal cancer screening. According to Cmdr. David You, the U.S. Navy gastroenterology specialty leader and a gastroenterologist at Lovell Federal Health Care Center in North Chicago, Illinois, this is important because men have a higher incidence of colon cancer. They are also more likely to develop colon polyps that can later turn into colon cancer if not removed. “If you are a 50-year-old male with no family history or risk factors, that’s the recommended age to get your first colonoscopy,” said You.

Critical risk factors include family history – if a parent or sibling has been diagnosed with colon cancer. For men with a first-degree family history of colon cancer, which means a parent has been diagnosed with the disease, screenings usually begin at age 40 and sometimes earlier if the family member was diagnosed before age 60, explained You. Furthermore, “Due to colon cancer diagnoses increasing in young men over the last 10 years, even without family history of colon cancer, some medical specialty groups advocate beginning screenings at age 45, in particular if you are African-American, since they have higher rates of colon cancer,” said You.

You’s patients echo the often-heard complaint about a colonoscopy: The preparation for the test is the worst part. It consists of nothing but clear liquids the day before the procedure and drinking a high volume of a prescribed liquid to clean the gastrointestinal tract starting the night before the procedure. As for the procedure itself, You said, “Often I hear, ‘That’s it?’ from my patients. Under light sedation, the procedure can be uneventful and it is truly the easiest part of the entire process.”

Less-invasive tests are available, including a yearly test called FIT (fecal immunochemical test) that looks for hidden blood in the stool. “These tests screen for colon cancer,” said You, “but if the results are positive for colon cancer indicators, you’ll still need a colonoscopy. The good news is that if your colonoscopy results are normal, your next test will be in 10 years if you have no family history or other risk factors.”

You explained that good health habits lower the risk of developing colon polyps. “Eat more fruits and vegetables, especially berries and leafy greens, keep your weight down and exercise, even one hour per week,” he suggested, adding that fiber is a key dietary addition. “Aim for 30 grams of fiber per day,” he said. “An apple has four and a bowl of bran cereal has 15, so getting to 30 grams isn’t as difficult as it may sound.”

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DoD Instruction 1010.10: Health Promotion and Disease Prevention

Policy

This instruction reissues DoD Directive (DoDD) 1010.10 (Reference (a)) as a DoD instruction (DoDI) in accordance with the authority in DoDD 5124.02 (Reference (b)) to establish policy and assign responsibilities for health promotion and disease prevention in accordance with References (c) through (f).

  • Identification #: DoD Instruction 1010.10
  • Date: 4/28/2014
  • Type: Instructions
  • Topics: Preventive Health
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