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
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 adults1	Every 2 to 4 years if no risk factors for eye disease
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	People at risk ²	2 doses given at least 6 months apart
Hepatitis B	People at risk ³	3 doses; 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 (or at least 4 months after the first dose)
Haemophilus influenza Type B (HIB)	People at risk	1 to 3 doses
Meningococcal	People at risk**	1 or more doses
Pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23)	People at risk ⁴	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