From Colonoscopies to Prostate Exams: What to Expect & When to Go
You wouldn’t wait for your engine to fail before finally getting an oil change. Don’t wait for symptoms before you see a doctor. Schedule the screenings you need to keep yourself healthy for your sake and for those who count on you.
Coryell Health has compiled a comprehensive guide to the screenings every man (or his spouse) should schedule. Not sure when you should get your first colonoscopy? Wondering what to expect at a urologist appointment? Click on your age group below or get the complete list of screenings featured in this blog to answer these questions and more.
You’re in Your 20s
Annual Physical Exam
Even if you’re perfectly healthy (or your youth makes you think you are), you should attend an annual physical exam starting in your 20s. Although you may not think you need annual physicals until you reach a certain age or develop a medical condition, it’s important to regularly assess your risk of developing health issues and keep your vaccines and other preventive care services up to date.
Starting at 20, you should have your blood pressure checked at least every other year. This can be taken care of during your annual physical. High blood pressure can lead to various health problems, especially those associated with the heart, so it’s important to monitor it regularly. If you currently have high blood pressure or are at risk of developing it, talk to your doctor about their recommendation for how often you should get screened.
Another significant contributor to heart disease can be high cholesterol. Starting at 20, men with an average risk of developing high cholesterol should get a cholesterol screening every five years. However, you should get screened more often than every five years if you:
- Smoke
- Maintain a poor diet
- Are overweight
- Have diabetes
- Are inactive
- Have a family history of heart attacks
- Or have a family history of high cholesterol
“Getting your cholesterol checked in your 20s helps establish a vital baseline for your long-term health,” says Dr. Colby Cessnun, family medicine physician at Coryell Health. “It allows us to track any changes over time and can also reveal genetic risk factors for high cholesterol early before symptoms develop.”
Annual Physical Exam
The American Academy of Ophthalmology recommends that adults in their 20s attend at least one eye exam to establish a baseline for their vision so it can be monitored over time. If you wear glasses or contacts or have any eye conditions, you should attend an annual eye exam.
Monthly Testicular Self-Exams
Lastly, you should conduct monthly testicular self-exams to check for any lumps, tenderness or other changes in your testicles. By noting these changes, you may detect minor conditions, like benign cysts or fluid retention, or something more serious, like testicular cancer. If you notice something out of the ordinary, schedule an appointment for a testicular exam with your urologist.
You’re in Your 30s
Annual Physical Exam
Once you’re in your 30s, your annual physical exams shouldn’t stop. Not only do they help detect warning signs of potential conditions, but they also help you maintain your relationship with your primary care physician in case you get sick.
According to Johns Hopkins, the average age of diagnosis for testicular cancer is 33 years old. Testicular cancer is the most common malignancy in men between 20 and 40 years old, but it also has a cure rate of more than 95%.
One of the most surefire ways to detect warning signs of testicular cancer is through the monthly testicular self-exams you started in your 20s. If you notice a lump or swelling in either testicle, a dull ache in your stomach or groin or sudden swelling of your scrotum, you should immediately see a urologist.
In your 30s, you should continue to have your blood pressure checked at least every other year. If you currently have high blood pressure or are at risk of developing high blood pressure, you should ask your doctor how often you should be screened.
When it comes to your cholesterol, you should get a cholesterol screening at ages 30 and 35 at minimum (continuing with the pattern of every five years starting at age 20). However, if you display any risk factors for developing high cholesterol, ask your doctor how often you should receive a cholesterol screening.
The American Diabetes Association recommends that all adults 35 or older schedule routine tests for Type 2 diabetes. Staying aware of your blood sugar levels and your risk of developing diabetes is essential, as Type 2 diabetes and prediabetes symptoms tend to show themselves slowly. You should also be tested for Type 2 diabetes if you’re:
- Younger than 35, either overweight or obese and display one or more risk factors related to diabetes
- Someone who has been diagnosed with prediabetes
- A woman who has had gestational diabetes
- An overweight or obese child who has a family history of Type 2 diabetes
If your results are normal, you should continue to get tested for Type 2 diabetes every three years. Talk to your doctor about how often you should be tested if your results are abnormal.
If you have healthy vision, you should attend at least two eye exams between the ages of 30 and 39. This is to help you track how your vision is doing before your “complete” eye exam occurs at age 40. If you wear contacts or glasses or have eye problems, you should continue to attend annual eye exams.
You’re in Your 40s
Annual Physical Exam
In your 40s, you should continue to attend an annual physical exam, check your blood pressure at least every other year and get tested for Type 2 diabetes every three years unless your doctor recommends you get tested more often. Continuing to conduct monthly testicular self-exams will help you monitor any unusual symptoms that you may want to inform your urologist of.
If you’re over the age of 45, it’s recommended that you schedule a cholesterol screening more often than every five years. According to the National Heart, Lung and Blood Institute, high cholesterol is most commonly diagnosed in people ages 40 to 59. As you age, your body’s metabolism changes, and your liver doesn’t remove “bad” cholesterol as effectively as it used to. Talk to your doctor about how often you should receive a cholesterol screening.
Colonscopy
Colonoscopies allow doctors to examine the inside of your colon (your large intestine) and detect any signs of colon cancer or precancerous polyps. If you’re wondering what to expect at a colonoscopy, a long, flexible tube called a colonoscope is inserted into your rectum. A small video camera at the tip of the tube then allows your doctor to view the inside of your colon. It’s simpler than it seems, and it could save your life.
When you turn 45, it’s time for your first colonoscopy if you display an average risk for developing colon cancer. However, if you display risk factors of colon cancer, it’s recommended you begin scheduling colonoscopies before age 45. According to the American Cancer Society, African Americans are about 20% more likely to develop colon cancer and about 40% more likely to die from it than other racial groups. Other risk factors for developing colon cancer include:
- A family history of colorectal cancer or certain types of polyps
- A personal history of colorectal cancer or certain types of polyps
- A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
- A known or suspected family history of a hereditary colorectal cancer syndrome, like familial adenomatous polyposis (FAP) or Lynch syndrome
- A personal history of radiation to the abdomen or pelvic area to treat a prior cancer
If you have a family history of colon cancer, you should get your first colonoscopy 10 years before the age at which your immediate family member was diagnosed. For example, if your father was diagnosed with colon cancer at age 50, you should get screened at age 40. Additionally, if you show any of the following symptoms of colon cancer, ask your doctor about scheduling a colonoscopy no matter your age:
- Pain in your abdomen
- Blood in your stool
- Changes in your bowel habits, like diarrhea or constipation
- Passing excessive amounts of gas
- Anemia
“When colon cancer runs in the family, early screening is critical,” says John Bawduniak, MD, general surgeon at Coryell Health. “Starting screenings earlier gives us the best chance to detect issues before they become serious—or prevent them altogether.”
Early signs of eye disease generally start to make themselves known from ages 40-65, so when you turn 40, it’s time to schedule a “complete” eye exam. This eye exam goes beyond basic vision screenings and looks for signs of cataracts, glaucoma, diabetic retinopathy, macular degeneration due to aging and more. After this exam, your optometrist or ophthalmologist will tell you how often you should get your vision checked, and you need to follow that schedule over time.
You’re in Your 50s
Annual Physical Exam
During your 50s, you should continue to schedule annual physical exams, check your blood pressure at least every other year, schedule regular colonoscopies based on your doctor’s recommendation and get tested for Type 2 diabetes every three years unless your doctor recommends you get tested more often.
Since you’re over the age of 45, it’s recommended that you schedule a cholesterol screening more often than every five years. Ask your doctor how often you should check your cholesterol. It’s also important to continue conducting monthly testicular self-exams to identify any abnormalities you may want to inform your urologist of.
Prostate Exam
At age 50, if you’re at average risk of developing prostate cancer, you should start scheduling prostate exams every three to five years. However, according to the American Cancer Society, African American men and men whose father or brother (first-degree relative) was diagnosed with prostate cancer before they were 65 should start getting screened for prostate cancer at age 45. If you’ve had more than one first-degree relative diagnosed with prostate cancer before they were 65, you should start getting screened at age 40.
“A prostate exam is a useful tool in early detection—especially for men over 50. It allows us to identify potential prostate cancer or benign prostatic hyperplasia (BPH). Early detection greatly improves treatment options and outcomes.” – Dr. David Pinkstaff, Urologist, Coryell Health – “Most men should begin prostate cancer screening around age 50—but that’s not one-size-fits-all. Men at higher risk, particularly African American men or those with a family history, should consider starting as early as age 40. Early screening increases the chances of detecting cancer at a treatable stage, which can greatly improve long-term health outcomes.”
If you’re wondering what to expect at a prostate exam, there are two main portions of a prostate exam: a prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE). The PSA blood test is more effective at detecting prostate cancer than a DRE, but it doesn’t hurt to do both.
During a PSA blood test, your urologist will draw a blood sample and send it to the lab for analysis. In a DRE, your urologist will insert a lubricated, gloved finger into your rectum and feel your prostate to see if there are any other lumps or abnormalities on the back of the prostate gland, where many cancers start.
The U.S. Preventive Services Task Force recommends annual lung cancer screenings using a low-dose CT scan for adults ages 50-80 who:
- Currently smoke or have quit smoking in the last 15 years, and
- Have a 20-pack-year or more smoking history
A pack-year means smoking an average of one pack of cigarettes per day for one year. A 20-pack year could mean smoking one pack a day for 20 years or two packs a day for 10 years.
“Annual lung cancer screenings with a low-dose CT scan are an important tool for those at higher risk, especially individuals with a history of smoking. It can detect lung cancer early, when it’s most treatable. But the most effective way to reduce your risk is to quit smoking.” – Dr. Colby Cessnun, Family Medicine Physician, Coryell Health Medical Clinic – McGregor
Finally, follow your optometrist’s or ophthalmologist’s instructions from your “complete” eye exam at age 40 regarding how often you should attend eye exams throughout your 50s.
You’re in Your 60s or Older
The following tests and screenings should continue throughout your 60s and onward:
- Annual physical exams
- Checking your blood pressure at least every other year
- Cholesterol screenings more often than every five years (follow your doctor’s recommendation on how often you should get screened)
- Monthly testicular self-exams
- Colonoscopies every 10 years
- Prostate exams every three to five years for those who pose an average risk of developing prostate cancer
- Tests for Type 2 diabetes every three years unless your doctor recommends you get tested more often
- Annual lung cancer screenings for those who currently smoke or have quit smoking in the last 15 years and have a 20-pack-year or more smoking history
- Regular eye exams based on your optometrist’s or ophthalmologist’s recommendations
Additionally, the U.S. Preventive Services Task Force recommends a one-time abdominal aortic aneurysm (AAA) screening for men ages 65-75 who have ever smoked. However, men over 60 with a family history of AAA should attend regular screenings. Ask your doctor about how often you should receive AAA screenings.
This painless ultrasound test helps detect an enlarged part of the aorta, the body’s largest artery. Most people show no warning signs or symptoms indicating they have an AAA in the lower part of their aorta until it bursts, and a ruptured AAA can cause deadly bleeding since the aorta is the body’s main supplier of blood.
Meet the Doctors
Dr. David Pinkstaff, MD
Dr. David Pinkstaff is a board certified urologist with over 20 years of experience providing comprehensive urologic care to Central Texans. He earned his bachelor’s degree in chemistry from Texas Christian University and completed his residency in urology at the Mayo Clinic in Jacksonville, Florida. Dr. Pinkstaff earned his doctorate from UT Southwestern Medical School in Dallas. His specialties include diagnosing and treating voiding dysfunction, urinary incontinence, urinary tract infections, benign prostatic hyperplasia, kidney stones, urologic cancers and more.
Dr. John Bawduniak, MD
Dr. John Bawduniak is a board certified general and vascular surgeon with almost 20 years of experience caring for Central Texans. He earned his bachelor’s degree from Rice University, earned his doctorate from UT Southwestern Medical School and completed his residency in general surgery at the University of Texas Medical Branch at Galveston. His specialties include head and neck surgery, breast surgery, oncologic surgery, vascular surgery, endovascular surgery, vein surgery, complex laparoscopic surgery, acid reflux surgery, complex hernia repair, pediatric surgery, pancreatic and liver surgery and minimally invasive surgery using the da Vinci system.
Dr. Colby Cessnun, MD
Dr. Colby Cessnun is a board certified family medicine physician at Coryell Health’s McGregor clinic. He earned his bachelor’s degree from Texas A&M University, earned his doctorate at McGovern Medical School and completed his residency in family medicine in Waco, Texas. Dr. Cessnun’s dedication to caring for patients has also taken him across the world to Uganda, where he and his family spent over seven years serving as medical missionaries. In his practice, Dr. Cessnun strives to embody the love of Christ through compassionate care. His patient-centered approach emphasizes active listening and encouragement.
Whether you’re 20 or 60 years young, it’s essential to take care of yourself and commit to attending the regular screenings recommended for your age group. Investing in your health now will pay off for decades to come, and you and your loved ones will thank you for it.
To schedule a prostate exam with Dr. Pinkstaff, please call (254) 865-2166. If you’d like to schedule a lung cancer screening using a low-dose CT scan, please call (254) 248-6238.
