Prevention Guidelines for Men 65+

Screening tests and vaccines are an important part of managing your health. A screening test is done to find diseases in people who don't have any symptoms. The goal is to find a disease early so lifestyle changes and checkups can reduce the risk of disease. Or the goal may be to find it early to treat it most effectively. Screening tests are not used to diagnose a disease. But they are used to see if more testing is needed. Health counseling is important, too. Below are guidelines for these, for men ages 65 and older. Talk with your healthcare provider to make sure you’re up to date on what you need.

Screening	Who needs it	How often
Abdominal aortic aneurysm	Men ages 65 to 75 who have ever smoked	1 ultrasound
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 is higher than normal, follow the advice of your healthcare provider.
Colorectal cancer	All men at average risk in this age group through age 75 who are in good health. For men ages 76 to 85, talk with your healthcare provider to see if you should continue screening. For men 85 and older, screening is not advised.	Several tests are available and are used at different times. For tests that find polyps and cancer: Flexible sigmoidoscopy every 5 years, or Colonoscopy every 10 years, or CT colonography (virtual colonoscopy) every 5 years For tests that mainly find cancer: Yearly fecal occult blood test, or Yearly fecal immunochemical test, or Stool DNA test every 3 years You will need a colonoscopy if you choose a different test and have an abnormal test result, Screening advice varies among expert groups. Talk with your healthcare provider about which tests are best for you. Some people should be screened using a different schedule because of their personal or family health history. Talk with your healthcare provider about your health history.
Depression	All men in this age group	At routine exams
Type 2 diabetes or prediabetes	All men starting at age 45 and men without symptoms at any age who are overweight or obese and have 1 or more extra risk factors for diabetes	At least every 3 years (annual testing if your blood sugar has begun to rise)
Type 2 diabetes	All men with prediabetes	Every year
Hepatitis C	Anyone at increased risk for infection	At routine exams
High cholesterol and triglycerides	All adults	At least every 5 years
HIV	Anyone at increased risk for infection	At routine exams
Lung cancer	Adults ages 55 to 80 who have smoked	Yearly screening in smokers with 30 pack-year history of smoking or who quit within 15 years
Obesity	All adults	At routine exams
Prostate cancer	All men in this age group, talk to healthcare provider about risks and benefits of digital rectal exam (DRE) and prostate-specific antigen (PSA) screening***	At routine exams
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 1 to 2 years. If you have a chronic disease, ask your healthcare provider how often you need an exam.
Counseling	Who needs it	How often
Aspirin for primary prevention of cardiovascular events	Men ages 45 to 69 when potential benefits from a decrease in heart attacks outweigh the harm or risks from an increase in gastrointestinal bleeding	When diagnosed with a risk for cardiovascular disease. Check with your healthcare provider before starting
Diet and exercise	Adults who are overweight or obese	When diagnosed and at routine exams
Fall prevention (exercise, vitamin D supplements)	All men in this age group	At routine exams
Sexually transmitted infection prevention	Anyone at increased risk for infection	At routine exams
Tobacco use and tobacco-related disease	All adults	Every visit
Immunization	Who needs it	How often
Tetanus/diphtheria/pertussis (Td/Tdap) booster	All adults	Every 10 years. Tdap is advised if you have contact with a child younger than 12 months. Either Td or Tdap can be used if you have no contact with infants.
Chickenpox (varicella)	All adults ages 65 and older who have no previous infection or vaccine**	2 doses. The second dose should be given at least 4 weeks after the first dose.
Flu (seasonal)	All adults	Yearly, when the vaccine is available
Haemophilus influenzae type B (HIB)	People at risk	1 to 3 doses
Hepatitis A	People at risk, such as travelers	2 doses given at least 6 months apart. These should give long-lasting protection
Hepatitis B	People at risk, such as travelers and those with chronic liver disease	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)
Pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23)	All adults ages 65 and older	1 dose of each vaccine
Zoster	All men ages 60 and older	2 doses of the Recombinant Zoster Vaccine (RZV), 2-6 months apart. RZV is advised even for people who have had the live shingles vaccine called Zostavax. There is no live virus in RZV.

*From the American College of Cardiology and the American Heart Association Task Force on Clinical Practice Guideline

**There may be exceptions. Talk with your healthcare provider.

***National Comprehensive Cancer Network

If the test is positive, a colonoscopy should be done.

The multiple stool take-home test should be used. One test done by the healthcare provider in the office is not enough for testing. A colonoscopy should be done if the test is positive.

1 From the American Academy of Ophthalmology

Screening guidelines from the U.S. Preventive Services Task Force, except Hepatitis C from CDC

Vaccine schedule from the CDC