A Test a Day: Making Sense of Health Screenings with Help from Your Primary Care Physician

Sep 6, 2013 - 

Make a plan to live healthier

You may have heard the term sustainable healthcare lately – the idea is simple, a focus on keeping patients well instead of treating them only when they are sick. Together with your primary care physician you can make plans to live healthier every day.

Start with screenings at the right ages for early detection
One important component is age-appropriate screenings for serious diseases. If your primary care doctor finds a disease early, the problem is often easier to treat and may cause less damage. In addition to celebrating milestone birthdays, consider them reminders for certain important health checks.

Note: Screening means testing for a condition before there are signs or symptoms of disease. If you already have symptoms of any of the following, be sure to see your doctor right away.

Here's a timeline for health screenings by age and gender
A= Annually 18-25 30-35 40-45 50 60 65
WOMEN Cervical cancer (A)

Blood pressure

Clinical breast exams (A)
Eye exam (once) Mammograms (A)

Diabetes

Cholesterol

Eye exam
Colorectal cancer (A)   Osteoporosis
MEN Blood pressure Cholesterol Diabetes Prostate cancer (A)

Colorectal cancer (A)
  Abdominal aneurysm

Types of tests your primary care physician may recommend
  • Breast cancer. Mammograms use x-rays to look for breast cancers when they are still small. The American Cancer Society (ACS) recommends annual mammograms for women starting at age 40. Talk with your primary care doctor about frequency, as well as other possible imaging tests if you have a family history of breast cancer. Keep in mind that while mammograms are the best way to detect early cancer, you should also know your breasts feel normally and report any changes to your primary care doctor.
  • Prostate cancer. The ACS suggests that men talk with their primary care doctor at age 50 about whether they should be tested for prostate cancer. This screening involves a blood test measuring a substance called PSA. It may also include a rectal exam of the prostate. African-American men and men with a father or brother who had prostate cancer before age 65 should have this talk at age 45.
  • Osteoporosis. The U.S. Preventive Services Task Force (USPSTF) suggests that women be screened for osteoporosis starting at age 65. Your doctor might advise you to start at a younger age if you are at high risk for bone loss or a broken bone.
  • Colorectal cancer. The ACS suggests that both men and women be screened for colorectal cancer starting at age 50. The gold standard diagnostic test is the colonoscopy. If no precancerous polyps are found, you may not need to have the test repeated more than once every 10 years. If you have a family history of colon or rectal cancer, you may need to be tested earlier.
  • Diabetes. The National Institutes of Health suggests that everyone age 45 or older think about being tested for diabetes. Consider starting at a younger age if you're overweight and have other factors that put you at higher risk for diabetes, such as an elevated blood glucose level, high cholesterol, high blood pressure or family history of diabetes.
    • Cholesterol. The USPSTF suggests that men have cholesterol screenings starting at age 35. Women should begin at 45 if they're at high risk for heart disease. Both men and women should consider getting this blood test at an earlier age if their risk for heart disease is particularly high.
    • Blood pressure. All adults should be screened for high blood pressure once a year. If the blood pressure is in the low normal range, it can be extended to every two years.  
    • Abdominal aneurysm. Men should have a one-time screening for abdominal aortic aneurysm between ages 65 and 75 if they have ever smoked, the USPSTF suggests. This ultrasound test looks for a weak, bulging spot in a major blood vessel in the abdomen. The USPSTF doesn't recommend the screening in older men who haven't smoked, or in women.
    • Cervical cancer. Women should be screened at least every three years. After age 65 or after a hysterectomy for benign disease, women may stop having Pap smears as long as their previous Pap smears were normal and they are not otherwise at high risk for cervical cancer.  
    • Clinical breast exam. The ACS recommends clinical breast exams (CBEs) at least every three years for all women in their 20s and 30s and annual CBEs for women ages 40 and older. The USPSTF, however, believes there is not enough evidence to assess the value of CBEs for women ages 40 and older. Women should talk with their doctors about their personal risk factors and make a decision about whether they should have a CBE.
    • STD Tests. Tests for sexually transmitted diseases (STDs). Have STD tests if you're sexually active and you and your partner aren't monogamous.
    • Eye exam. You should have a complete eye exam at least once between the ages of 20 and 29 and at least twice between the ages of 30 and 39, according to the American Academy of Ophthalmology. Have an eye exam at the age of 40, at which time your doctor can recommend how frequently you should follow up; after age 65, have an exam every one to two years.
    • Skin exam. Each time you have a health checkup, have your provider examine your skin for skin cancer and precancerous conditions. Learn the signs of skin cancer so you can examine your own skin regularly.
How your primary care doctor will use your results
As you gather information from screenings, your primary care doctor can offer suggestions to improve your health based on your results. For example, high blood pressure, or hypertension, can sometimes be addressed by increasing aerobic exercise like walking, running or cycling. Also keep in mind that the goal of screenings is early detection, so while the idea can be scary, ultimately finding things early could save your life.

Sources
Online Medical Reviewer: Fincannon, Joy, RN, MN
Online Medical Reviewer: Hanrahan, Maura, MD
Last Annual Review Date: 12/24/2012
© 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

Online Medical Reviewer: Fincannon, Joy RN, MN
Online Medical Reviewer: Haines, Cynthia MD
Online Medical Reviewer: Stump-Sutliff, Kimberly, RN, MSN, AOCNS
Last Annual Review Date: 3/26/2011
Copyright Health Ink & Vitality Communications

Online Medical Reviewer: Godsey, Cynthia M.S., M.S.N., APRN
Last Annual Review Date: 12/1/2003


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