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Men’s Health Screening for Optimal Health, Wellness and Vitality

Dr. Derek Koh


Dr. Derek Koh

Head, Health Screening at Thomson Wellth Clinic

MBBS (Singapore), GDFM (Singapore)

Dr. Derek Koh practises preventive medicine through tailored health screenings & wellness programmes including the management of Andropause, Menopause and Obesity. He is also Board Certified in Anti-Ageing; has attained his Fellowship with the American Board of Anti-Ageing.

Table of Contents

Men’s health screening is an important feature of preventative health. It offers the opportunity for early detection of health factors and lifestyle risks that can lead to the onset of chronic illness. Men’s health screening is a service provided to men who feel and look well. It is different to the diagnostic tests that are needed when a person is experiencing the symptoms of an illness or disease. In other words health screening among healthy people is the process used to detect health disorders or risk factors they are unaware of. Men’s health screening is a feature of primary prevention and is intended to promote health and protect against exposure to the risk factors that can result in future health problems. 
Health screening is also central to secondary prevention that is concerned with the detection of diseases at their earliest stage.  

What is primary and secondary prevention?

Health screening provides both primary prevention and secondary detection.
In primary prevention, health screening identifies the risk factors that could lead to health problems – in order to prevent future illness. It provides the physician with the facts and information needed to recommend any lifestyle interventions that may be needed.  
In secondary prevention, health screening enables early detection and diagnosis – before the disease has become symptomatic. This can ensure a prompt and timely intervention that will halt or slow down the progression of a disease. 

How often should we have a Health Screening?

Regular health screenings are important, as the detection of a disease or a change in health status may only be observed at the time of a specific health screening. Health screenings provide the opportunity to detect changes in health or lower the risk of developing a chronic disease. Cancer for example is Singapore’s biggest killer and when detected early is far less likely to result in premature death. Other chronic diseases such as obesity and diabetes are more easily managed when detected early. 

How relevant is age, in Men’s health screening?

Men’s health screening has many facets – for example, younger men in their twenties have different health priorities than older men. Health concerns vary according to age.  
A basic medical review, body index analysis, urine and stool analysis along with a chest x Ray and ECG may be all that is needed for younger men. This can provide a benchmark of current health for primary health prevention purposes. As we get older however, our health prevention and screening needs change, and the corresponding tests become more comprehensive. 

With all the health advantages – why do some men neglect health screening?

Despite all the advantages of health screening, uptake among men remains low. 
According to one study, a common factor in understanding why men prefer not to receive health screening is the fear of being diagnosed with a disease. Studies have found that younger men particularly, did not always recognize the importance of health screening as a feature of preventative health, and did not differentiate between screening and diagnosis. ‘They would go for a medical ‘check-up’ only when they had symptoms, such as pain .. it was the Asian culture to seek help from doctors when sick, not when they were healthy’ (Teo et al,2017).

Another barrier to health screening is that often men do not understand the screening process and believe there may be some pain associated with health screening. 
For example, procedures that may represent male barriers to health screening are digital rectal examination, colonoscopy and sigmoidoscopy (Teo et al,2016). For some men health screening is perceived as a threat to their masculinity. Studies have shown that they share the attitude that ‘real men are not concerned about their health’ (Shannon et al,2014).

Why are Men’s health screenings important?

Sedentary lives, lack of exercise, poor diets and stress will over time have an impact on health. Men’s health screening can diminish health risks by providing well-informed clinical recommendations. These are customized to the personal health needs of each individual. The preventative health advice received from physicians is intended to influence the factors that impact men’s health.   

It’s tough to make predictions, especially about the future

Quote by, Yogi Berra

Health screenings provide an opportunity to detect early disease and behavioural factors that may contribute to poor health and increase the risk of future illness. Health screenings are undertaken when there are no symptoms. Diagnostic tests are used to confirm a suspected condition. Tests provide clinically important information, and in the event of an underlying condition, enable the physician to decide upon an appropriate intervention (Gilbert et al, 2001). 

The prevention and detection of illness is a prime reason why men should plan to have periodic health screenings. The warning signs of many chronic diseases such as cardiovascular (heart) disease, diabetes and some cancers can more easily be picked up in their early stages with regular screening. The chances of overcoming or surviving 
these conditions are greatly improved with early intervention. For example, the signs of developing hypertension can be detected when blood pressure is tested. Low or high blood pressure can be regulated through an improved diet and regular exercise. In contrast, if ignored, the development of hypertension is a serious chronic condition that may require lifelong medication which may have side effects and an undesirable impact on lifestyle. 

Early detection is the key.

The relevance of early detection of health risks associated with a chronic disease is demonstrated by i.e the increasing prevalence in Singapore of Type 2 Diabetes. Research has shown that by 2050, 31-39% of Chinese men in Singapore aged 60-69 will suffer from type 2 Diabetes. The statistics are higher among Malay and Indian Singaporeans (Phan et al, 2014). Therefore a person aged perhaps 28 now, could be among the dire statistics of that future forecast. However, a health screening can diminish the risk of developing diabetes, with the needs identified for health and lifestyle changes. Diabetes Type 2 in Singapore is associated with high calorific lifestyles, obesity, and a lack of exercise. A lifestyle management plan tailored to an individual’s needs can minimize the risk of developing Type 2 Diabetes. 

My G.P can do the tests.

Opportunistic tests with a health provider are unlikely to be as comprehensive as health screening by a practitioner who is dedicated to the many facets of preventative health and holistic care.  In addition, men do not usually visit their G.P unless they are presenting with a current health need. Therefore the motivation to take primary preventative health measures may not arise in this context.   

Cancers and early detection

In Singapore cancer is the leading cause of death and the risk increases with age.  
Screening for cancer increases survival rates substantially.  In older men particularly, health screening should include a PSA screening (Prostate Specific Antigen) for early signs of Prostate Cancer. A slow but progressive potentially lethal disease and like all cancers is more easily treated when detected early. In European and U.S studies men aged over 55 to 74 that were screened were found to have up to a 32% lower risk of cancer death when undergoing regular health screening for cancer (Tsodikov et al ,2017) 

Barriers to young men and health screening

The poor outcomes for cancers diagnosed at an advanced stage have been the driver behind research into techniques to detect disease before symptoms manifest. Early, detection and treatment can prevent the development of most cancers. During the last three decades screening has become a major element of cancer control through a combination of primary and secondary prevention.

Studies have shown that men frequently have poorer health status, and are less like to attend health screenings than women. Men aged 20-35 have hypertension rates at just 10% in those age groups. However, by the age of 40 – 54 hypertension increases significantly to 40%. Therefore recognizing risk factors while men are young provides a window of opportunity to minimize the possibility of succumbing to chronic disease later in life 
(Teo et al,2016;Teo et al,2017). The potential for developing a chronic disease at an older age is high when health screening and lifestyle management are ignored.                                         


Brauer, Paula, Sarah Connor Gorber, Elizabeth Shaw, Harminder Singh, Neil Bell, Amanda R. E. Shane, Alejandra Jaramillo, Marcello Tonelli, and Canadian Task Force on Preventive Health Care. 2015. “Recommendations for Prevention of Weight Gain and Use of Behavioural and Pharmacologic Interventions to Manage Overweight and Obesity in Adults in Primary Care.” CMAJ: Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne 187 (3): 184-95

Christy, Shannon M., Catherine E. Mosher, and Susan M. Rawl. 2014. “Integrating Men’s Health and Masculinity Theories to Explain Colorectal Cancer Screening Behavior.” American Journal of Men’s Health 8 (1): 54-65.

Creative, Bam. n.d. “Health in Men Study – Harry Perkins Institute of Medical Research.” Accessed March 11, 2018.

Gilbert, R., S. Logan, V. A. Moyer, and E. J. Elliott. 2001. “Assessing Diagnostic and Screening Tests: Part 1. Concepts.” The Western Journal of Medicine 174 (6): 405-9.

Tsodikov, Alex, Roman Gulati, Eveline A. M. Heijnsdijk, Paul F. Pinsky, Sue M. Moss, Sheng Qiu, Tiago M. de Carvalho, et al. 2017. “Reconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO Trials.” Annals of Internal Medicine 167 (7): 449-55.

Norman, Paul E., Leon Flicker, Osvaldo P. Almeida, Graeme J. Hankey, Zoë Hyde, and Konrad Jamrozik. 2009. “Cohort Profile: The Health In Men Study (HIMS).” International Journal of Epidemiology 38 (1): 48-52.

Phan, Thao P., Leontine Alkema, E. Shyong Tai, Kristin H. X. Tan, Qian Yang, Wei-Yen Lim, Yik Ying Teo, et al. 2014. “Forecasting the Burden of Type 2 Diabetes in Singapore Using a Demographic Epidemiological Model of Singapore.” BMJ Open Diabetes Research & Care 2 (1): e000012.

Report, Annual. n.d. “SINGAPORE CANCER SOCIETY.”

“The Meaning of Secondary Prevention.” 2011. Science-Based Medicine. January 11, 2011.

Teo, Chin Hai, Chirk Jenn Ng, and Alan White. n.d. “Factors Influencing Young Men S ‘ Decision to Undergo Health Screening in Malaysia: A Qualitative Study.”

“The ABCs of Health Screening.”

Thorpe, Roland J., Jr, Janice V. Bowie, Shondelle M. Wilson-Frederick, Kisha I. Coa, and Thomas A. Laveist. 2013. “Association between Race, Place, and Preventive Health Screenings among Men: Findings from the Exploring Health Disparities in Integrated Communities Study.” American Journal of Men’s Health 7 (3): 220-27.

Wardle, Jane, Kathryn Robb, Sally Vernon, and Jo Waller. 2015. “Screening for Prevention and Early Diagnosis of Cancer.” The American Psychologist 70 (2): 119-33.

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Urine and Stool Analysis

A urine sample is collected to examine substances such as glucose, protein, and red or white blood cells to provide information about kidney function & other urinary tract-related medical conditions. A stool analysis, on the other hand, checks for blood to provide information about digestive health including potential gastrointestinal bleeding.

Body Analysis Index (BIA)

A technique used to measure various parameters related to body composition, such as body fat percentage & lean body mass. It is non-invasive and involves passing a small electrical current through the body and measuring the resistance of different tissues to the current.