By Dr Luke Dunne, Epworth Freemasons GP Clinic
The importance of health checks as we age
Health checks are important for identifying modifiable health risks and the early detection of emerging problems.
The human body is an amazing machine, but, like any machine, there is deterioration with age. Unfortunately, our risk of serious illness increases as we progress through our lifespan. Just as we get our cars checked and serviced to reduce the chance of them breaking down, we need to do the same for ourselves.
Why men and women need different health checks
Much preventative health is common to men and women, such as heart health, skin checks and bowel cancer screening. The differences essentially come down to our anatomy and physiology. For example, whereas women are at risk of cancers of the cervix, ovaries and uterus, men are at risk of prostate cancer. According to the Cancer Council, prostate cancer is the most diagnosed cancer in Australia, with an estimated one in six males diagnosed by the time they are 85. However, if diagnosed early, prostate cancer has one of the highest five-year survival rates.
Unlike women, who are often introduced to regular health screenings from a young age- such as Pap smears, breast checks, and GP visits for contraception - men typically don't develop the same routine health-seeking behaviours.
This makes early detection for men especially important, as they are more likely to delay seeking help until symptoms become severe. Many men live with ongoing issues- such as erectile dysfunction, urinary issues or digestive problems - without realising these may be signs of underlying health concerns.
I would encourage men to be proactive about their health. A simple conversation with a GP can lead to a referral to Epworth, where we can support them in addressing a range of health issues.
Health checks over the decades
Ideally, health checks, including blood pressure, should start well before age 40, but if you get to your early 40s without having a regular GP, it is certainly time to find one. Men may feel invincible in their 20s and 30s, but by our 40s we have reached midlife, and it is important to start thinking seriously about our future health.
By your early 40s, you should have a thorough check-up, including history and a full physical examination. You should also be discussing with your GP screening tests for things like bowel and prostate cancer, high cholesterol and type 2 diabetes. Your GP will consider your individual circumstances, including family history, when recommending when to begin these tests. Personal risk factors such as smoking, alcohol, diet and weight should be addressed, and you should have a heart disease risk assessment.
Screening tests and regular GP check-ups should continue through your 50s and 60s. The appropriate frequency of checks will be recommended by your doctor based on your history, but, as a rule, for patients at average risk of bowel or prostate cancer the screening frequency for these conditions is two-yearly.
In recent years, there has been a lot of interest in CT coronary calcium scoring in asymptomatic patients to detect plaque that may be building up in the coronary arteries, which could lead to heart attack. The optimal age for this test, which is not currently funded by Medicare, is not clearly defined, but it is generally most useful in those aged over 45. It should be emphasised that coronary heart disease remains a common cause of death in Australia.
Of course, irrespective of screening results, symptoms such as chest pain and shortness of breath at any age are medical emergencies that require immediate assessment. Similarly, any persistent pain or the emergence of symptoms such as unexplained weight loss, night sweats, skin lesions, a change in bowel habit or blood in the sputum, urine or faeces are red flags that warrant prompt investigation.
As for asymptomatic screening into our 70s and beyond, this is an individual matter best discussed with your doctor. Notably, the National Bowel Cancer Screening Program ends at age 74. Of course, regular review by your GP should continue, and any symptoms that may arise should be assessed. There is also a funded vaccination program for older Australians, including influenza, COVID-19, shingles and pneumococcal pneumonia.
It is always important to check in with your GP about your mental health, no matter how old you are.
The impact of family history and other factors
Family history is important and should be carefully considered by your GP. For many conditions, a family history does increase our risk.
For example, a family history may increase your risk of bowel cancer, and, for those with a strong family history, colonoscopy, as opposed to the faeces test, is the recommended primary screening tool. Similarly, if you have a family history of heart disease, you may have a higher risk of developing a heart condition and this may warrant closer surveillance.
A small percentage of certain cancers are due to an identifiable inherited genetic defect. If your GP thinks that the constellation of cancers in your family history may be linked to an inherited faulty gene, they may refer you to a specialist genetics service.
Lifestyle is a very important factor in our health. Smoking, alcohol and other drug use are significant risk factors, as are poor diet, lack of exercise and obesity. These are modifiable risks, and your GP is a great person to provide guidance and help.
Your sex life could also be placing you at risk, and your GP can provide sexual health screening and advice about safer sexual practices. A medication for the prevention of HIV infection is PBS-subsidised for at-risk groups.
Also, the National Lung Cancer Screening Program has commenced in July this year and it offers two-yearly low-dose CT scans to detect lung cancer in asymptomatic patients aged 50 to 70 who are deemed to be at high risk due to smoking. Lung cancer is another common cause of cancer death in Australia.
Arranging a health check
Your GP is best placed to advise you about full range of preventative health measures available.
In the case of bowel cancer, the National Bowel Cancer Screening Program also sends test kits directly to persons aged 50 and over every two years. Since 2024, persons aged 45 and over can elect to join the program, either directly or through their GP.
