Men’s preventive health check-up items

There is no universal "one-size-fits-all package" for men's preventive health examinations. The core logic is "age stratification + risk customization": 20-30 year olds focus on infectious diseases and basic metabolic screening, 30-40 years old add early warning of chronic diseases and reproductive system-related examinations, 4 The most cost-effective solution is to focus on tumor markers and cardiovascular and cerebrovascular risks between the ages of 0 and 50, and to supplement screening for bone density, gastrointestinal endoscopy and other high-risk diseases in the elderly over the age of 50. In addition, special tests should be combined with personal conditions such as smoking, alcoholism, and family history. This is the most cost-effective solution.

I have been working as a medical assistant in a physical examination center for almost 6 years, and I have seen too many men go to extremes, either relying on their youth and not getting checked for several years, or choosing the most expensive package worth tens of thousands of dollars, thinking that the more expensive the better. Last month, I met a 42-year-old manufacturing boss. He spent 26,000 on a PET-CT, but it turned out that the prostate-specific antigen (PSA), which costs dozens of dollars, was not even included in the package. Later, he went to the urology department because of pain during urination, and was found to have early-stage prostate cancer. If he had added this to his physical examination, he would not have had to undergo a puncture later. Speaking of which, there is quite a controversy in the academic circles over whether ordinary people should undergo PET-CT for physical examination. One group thinks that the radiation dose of this project is not small, and the accuracy of screening for common cancers is not as exaggerated as advertised. Ordinary people are wasting money and suffering from radiation every year. ； The other group believes that if you have a clear family history of cancer, or you are a high-risk group who smokes and drinks alcohol for a long time, it is okay to do it once every 3-5 years. This choice depends on your personal situation, and there is no need to blindly chase the price.

Don’t think it’s normal to stay up late eating barbecue and drinking cold beer when you’re in your twenties. The last time I treated a 22-year-old young man who had just graduated from an operation position, his uric acid level soared to 620 during his physical examination. He was still confused and said that he felt nothing but an occasional tingling in his toes. In this age group, in addition to the basic items such as hematuria, liver and kidney function, and chest X-ray that must be checked, you must remember to add Helicobacter pylori insufflation, hepatitis B two and a half - if you are found to have no hepatitis B antibodies, quickly get the vaccine, and uric acid. Really, there are more young people with high uric acid than old men and women. If you have had unprotected sex, don’t be embarrassed and get screened for four sexually transmitted diseases. Many syphilis and genital warts have no obvious symptoms in the early stages. It is really troublesome when they are found to have infected their partners.

When you reach 30 years old, the burden on your shoulders suddenly becomes heavier. There are seniors and juniors, and it is common to work overtime and socialize. The focus of physical examinations must also be adjusted accordingly. My cousin is 35 years old. He is 175cm tall and weighs almost 190cm. His snoring at night can wake up his nephew who is sleeping in the next room. Last year, I forced him to have a sleep breathing monitor, and he was found to have severe OSAHS (sleep apnea hypopnea syndrome). The doctor said that if we wait for another year or two, there is a real possibility of sudden death in sleep. Now I have been wearing a ventilator for half a year, and I am not sleepy at work during the day. In addition to the basic items mentioned above, this age group must also have dynamic monitoring of blood lipids and blood sugar, and do an abdominal B-ultrasound every year to see if there is fatty liver. For programmers and drivers who sit for a long time, it is best to get a cervical and lumbar spine CT. Don’t think that neck pain is a minor problem. Severe compression of nerves will cause numbness in the hands and wobbly walking. By the way, if you can easily check your semen during the pregnancy preparation period, it is also recommended to have a testicular B-ultrasound every year if you are not preparing for pregnancy. Nowadays, the age of onset of testicular cancer is getting younger and younger. If detected early, the cure rate is almost 100%. Oh yes, there is also a controversial point here: Should I have a prostate examination in advance at the age of 30? There are indeed two clinical views at present. One group believes that there is no need to check if there are no symptoms of frequent urination, urgency, or difficulty in urination. The other group believes that high-risk groups who sit for long periods of time and often hold back urine do not have any harm in having a prostate B-ultrasound every year. This can be chosen according to your needs.

The age of 40 is considered a hurdle for men's health. The incidence of many malignant diseases begins to rise sharply from this age. The 42-year-old boss I just mentioned is a typical example. He thinks that there is nothing wrong with him if he can eat and drink, but he ignores basic tumor marker screening. At this age, the three tumor markers, AFP (liver cancer screening), CEA (digestive tract cancer screening), and PSA (prostate cancer screening), must be added. The total cost is more than 200 yuan, which is cheaper than buying two packs of cigarettes. If you have long-term hypertension or have a family history of myocardial infarction, it is best to have a carotid artery B-ultrasound to see if there are plaques. If you are at high risk, consider coronary CTA. Many people are frightened when they hear gastrointestinal endoscopy and feel that intubation is too uncomfortable. Nowadays, painless gastrointestinal endoscopy can be done by sleeping for 20 minutes. The anesthetic is metabolized very quickly and it is not "brain-breaking" as mentioned on the Internet. If you really can't accept it, you can also choose capsule endoscopy, which is more expensive and has its own advantages and disadvantages. Regardless of whether you have stomach pain or constipation over the age of 40, it is best to do it once every 3-5 years. Early gastric cancer and intestinal cancer have almost no symptoms. If you wait until blood in the stool is detected, it will basically be in the middle and late stages.

When you are over 50 years old, your body function declines faster. All the items mentioned above must be retained, and a bone density test must be added. Many older men have osteoporosis without knowing it. They break bones when they fall, and it is too painful to lie down for several months. Chest X-rays have also been replaced with low-dose chest CT. Not only does it reduce radiation, the resolution is much higher than ordinary chest X-rays. It can detect early-stage lung cancer at the millimeter level. It is best for old smokers who smoke all year round to do it once a year. There is also PSA, which must be checked every year regardless of whether you have uncomfortable urination symptoms or not. Prostate cancer is the most common genitourinary system tumor in men in this age group. If detected early, the 5-year survival rate can reach 99%.

In fact, after all, physical examination is not to detect diseases and scare yourself, but to nip small problems in the bud. I have seen too many men who love to carry on. If they have a headache or a fever, they just take some painkillers to carry it. In the end, a minor illness turns into a serious illness. The money they spend is dozens or hundreds of times more than a physical examination, not to mention the suffering they suffer. By the way, here’s a little reminder: don’t believe the free physical examinations offered by flyers on the street. Many of them are meant to trick you into buying health care products. If you want to get tested, go to a regular public tertiary-level medical examination center or a reliable private physical examination center. Before the examination, tell the doctor a few words about your living habits and family history. The doctor will help you adjust the package. There is no need to waste money on useless items.