2018AAFP指南：初级保健成年男性健康体检.pdf

The Adult Well-Male Examination Joel J. Heidelbaugh, MD, University of Michigan Medical School, Ypsilanti, Michigan The adult well-male examination should provide evidence-based guidance toward the promotion of optimal health and well-being. The medical history should focus on tobacco and alcohol use, risk of human immunodefciency virus and other sexually transmitted infections, and diet and exercise habits. The physical examination should include blood pressure screen- ing, and height and weight measurements to calculate body mass index. Lipid screening is performed in men 40 to 75 years of age; there is insufcient evidence for screening younger men. One-time screening ultrasonography for detection of abdom- inal aortic aneurysm is recommended in men 65 to 75 years of age who have ever smoked. Screening for prostate cancer using prostate-specifc antigen testing in men 55 to 69 years of age should be individualized using shared decision making. Screening for colorectal cancer should begin at 50 years of age for average-risk men and continue until at least 75 years of age. Screening options include fecal immunochemical testing, colonoscopy, or computed tomography colonography. Lung cancer screening using low-dose computed tomography is recommended in men 55 to 80 years of age who have at least a 30-pack-year smoking history and currently smoke or have quit within the past 15 years. Immunizations should be updated according to guidelines from the Advisory Committee on Immunization Practices. (Am Fam Physician . 2018;98(12):729-737. Copyright © 2018 American Academy of Family Physicians.) The goals of the adult well-male examination are to and Afordable Care Act. Te life expectancy of U.S. men provide evidence-based guidance toward the promotion of in 2015 was 76.3 years, a