Question

During a comprehensive annual evaluation, a 62-year-old man is assessed at the primary care clinic. He has a past medical history of diet-controlled type 2 diabetes mellitus and essential hypertension. His current medications include amlodipine and atorvastatin. He reports feeling well overall, though he notes intermittent, mild lower back pain after heavy yard work; the pain lacks radiation and resolves rapidly with rest and acetaminophen. He denies any bowel or bladder incontinence, saddle anesthesia, or lower extremity weakness.

His substance use history reveals that he began smoking cigarettes at age 20, consuming 1.5 packs daily until he quit on his 50th birthday. He consumes alcohol occasionally but denies illicit drug use. He has been in a monogamous marriage for 35 years.

A review of his preventive health record demonstrates:
- A screening colonoscopy performed 4 years ago at age 58 revealed no polyps or abnormalities.
- Routine screening for HIV, hepatitis B, and hepatitis C conducted at age 55 was negative.
- Following his diabetes diagnosis at age 59, he received a dose of the 20-valent pneumococcal conjugate vaccine (PCV20).
- He completed the two-dose recombinant zoster vaccine series at age 56.
- He received a tetanus, diphtheria, and acellular pertussis (Tdap) booster 3 years ago.
- He received the seasonal influenza vaccine two weeks ago.

Recent laboratory studies from a separate visit two weeks ago show a hemoglobin A1c of 6.2% and an in-range lipid profile. His physical examination today, including a detailed neurologic assessment of the lower extremities, is entirely within normal limits.

Based on current clinical guidelines, which of the following is the most appropriate next step in the management of this patient?