Free health checks for men aged 60 and over in Lithuania: what you are entitled to

What you are entitled to at 60 and over

Three preventive programmes funded by the National Health Insurance Fund (Valstybinė ligonių kasa, VLK) are relevant at this age, and they are all arranged through your own family doctor (šeimos gydytojas). Two of them still cover you well past 60: prostate cancer screening runs to age 69 inclusive, and bowel cancer screening runs to age 74 inclusive. The third, the cardiovascular disease prevention programme, applies by age to people aged 40 to 60 inclusive — which means the year you turn 60 is the last year you qualify for it on age alone. All of these are free of charge for people covered by compulsory health insurance (PSDF, Privalomojo sveikatos draudimo fondas).

What each programme includes

• Prostate cancer programme: a PSA blood test. If PSA is above 3 ng/ml, a referral (siuntimas) to a urologist (urologas), who carries out a biopsy if one is needed.
• Bowel cancer programme: a faecal occult blood test — a FIT or gFOBT stool sample test (slapto kraujavimo testas). If the result is positive, a referral for a colonoscopy (kolonoskopija) and, if needed, a biopsy. MedlinePlus advises starting screening at 45 if you are not at higher risk, and having a FIT or gFOBT test every year; the VLK programme funds it once every two years for ages 50 to 74 inclusive.
• Cardiovascular disease programme (to age 60 inclusive): assessment of risk factors, blood glucose, cholesterol and triglyceride tests, an ECG (elektrokardiograma, EKG), which the programme uses to help identify people at high risk, and an individual prevention plan.
• A positive or raised screening result does not by itself confirm a diagnosis — it is the reason a referral for further testing is issued.

What changes once you pass 60

From the age of 61 the cardiovascular disease prevention programme no longer applies to you on the age criterion. Blood glucose, cholesterol, blood pressure measurement and an ECG are then ordered by your family doctor (šeimos gydytojas) on individual indication rather than under the age-based programme, and blood pressure is measured as a normal part of a consultation. The prostate and bowel cancer programmes are unaffected by this and continue to their own age limits — 69 and 74 inclusive. Those checks still matter after 60: MedlinePlus advises a cholesterol test every year for people older than 65, and a blood pressure check at least once a year for everyone aged 3 or over, more often if you are at higher risk.

How to get these checks

• Contact your own family doctor (šeimos gydytojas), who assesses your age and state of health.
• The doctor confirms which programme or programmes you fall into by age, and issues the referral (siuntimas).
• The tests are carried out at a facility that has a contract with the health insurance fund — you pay neither for the tests nor for the doctor's work.
• Your family doctor tells you the results and, if anything is outside the normal range, refers you to a specialist for further investigation.

Other tests to raise with your family doctor

Two further tests sit outside the three programmes above and are worth raising with your family doctor. Creatinine (kreatininas) is a blood test used to assess kidney function; MedlinePlus states that the risk of kidney problems is higher in people over 50 and in those with diabetes or high blood pressure. TSH (thyroid-stimulating hormone) is used to assess thyroid function, and in older people the signs of a thyroid disorder — tiredness, changes in appetite or weight — are often unclear, so it is worth asking about the test if you have them. Whether and when these tests are done is for your family doctor to decide.

When to see a doctor

The signs below need attention now, not at your next scheduled check.

• Trouble passing urine, blood in your urine, or needing to get up at night to pass urine — do not put off seeing your doctor.
• Bleeding from your back passage, a lasting change in your bowel habit, or losing weight without trying — see your doctor as soon as possible.
• Sudden chest pain, shortness of breath, or pressure in your chest — get help straight away: call 112, the emergency number in Lithuania. Do not wait for a scheduled test.
• Swelling in your hands or feet, severe tiredness, or changes in your urine — worth raising with your doctor, as these can point to a problem with your kidneys.

For the signs above that are not an emergency, contact your own family doctor (šeimos gydytojas) rather than waiting for the next scheduled check. In a medical emergency in Lithuania, call 112.

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