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Men are much less likely than their wives, sisters and mothers to see a doctor, according to a 2000 study by The Commonwealth Fund, a New York-based nonprofit that supports research on health and social services issues.

Three times as many men as women surveyed had not seen a doctor in the previous year. More than half the men hadn't had a physical or a cholesterol test in the past year, and one out of three had no regular doctor.

Preventive care, however, can literally mean the difference between life and death for some men.

Men already are at a disadvantage when it comes to life expectancy. They live an average of 74.4 years, while women on average make it to the ripe old age of 79.8, according to a 2003 report from the Centers for Disease Control and Prevention in Atlanta.

Seeing a doctor won't guarantee immortality, but it can't hurt. Regular checkups every few years before middle age allow doctors and patients to monitor blood pressure and cholesterol and sugar levels. Catching abnormal results early may help a patient avert heart problems, the No. 1 killer of men.

Once men hit 40, they should have cardiovascular health and diabetes screenings every two years, recommendations say. Some guidelines also call for annual fecal occult screens to detect early colon cancer.

After 50, men should increase their vigilance. The most stringent guidelines call for annual checks of blood pressure, diabetes and cholesterol. Others recommend the first two every one to two years and a cholesterol test every five years. Most agree that, after 50, men should undergo prostate cancer and colon cancer screening each year and a colonoscopy every decade.

But few men follow these suggestions. The Commonwealth Fund study found that men of all ages shirk the doctor. Among those 50 and older, one-third had been tested for neither prostate nor colon cancer in the past five years.

Men's avoidance of health care starts early in life, says Dr. Jean Bonhomme, a spokesman for the Men's Health Network, a Washington, D.C.-based nonprofit:

Boys are encouraged not to cry when they injure themselves. If they're hurt playing sports, they're told to take one for the team. By the time they're adults, they've learned to not seek help for problems.

"Men have a bad habit, because of the way we've been socialized, of ignoring the way we feel," Bonhomme says. "When you're young, that may not be too harmful, but as you get older, time changes the rules about ignoring the pain."

When men do go, it's often because their wives have prodded them to go to the doctor.

But these days, some doctors are seeing men make appointments of their own volition.

Consider it "the little blue pill" syndrome. Lured by the promise of Viagra or one of the other oral medications for erectile dysfunction, some men now are making the first move when it comes to their health, doctors say.

"There's got to be some positive benefits to seeing a Viagra commercial every 10 minutes," says Dr. Thomas Gardner, a urologist at Wishard Hospital in Indianapolis.

In a nod to the link between men's health and men's sexual wellness, the companies that market Levitra, an oral medication to treat erectile dysfunction, last year joined with the National Football League to sponsor a public education campaign. The campaign encourages men to be proactive about their health.

"All we're saying is, this is not a dress rehearsal. This is the real deal," says Mike Ditka, spokesman for the NFL's Tackling Men's Health campaign. "If you want to stay in the game, you have to do the things that you need to do."

Drew Voight

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