Screenings are medical tests that check for diseases before there are any symptoms. Screenings can help doctors find diseases early, when the diseases may be easier to treat. Getting screening tests is one of the most important things you can do for your health. Depending on your age and sex, you may need to be screened for:m Certain types of cancer
m High blood pressure or high cholesterol
m Diabetes
m Osteoporosis (weak bones)
m Sexually transmitted diseases (STDs)
m Hearing loss or vision loss
Different screening tests are needed at different ages. Check the screening guidelines below for your age and sex. Use these guidelines to start a conversation with your doctor about screening.
Exams and screening tests: women (Ages 40-64 years)
There are specific times when you should see your provider. Below are screening guidelines for women ages 40 - 64.
Blood pressure screening
m Have your blood pressure checked every 2 years. If the top number (systolic number) is between 120 - 139 or the bottom number (diastolic number) is between 80 - 89 mm Hg or higher, have it checked every year.
m Watch for blood pressure screenings in your area. Ask your provider if you can stop in to have your blood pressure checked. Or check your blood pressure using the automated machines at local grocery stores and pharmacies.
m If the top number is greater than 140, or the bottom number is greater than 90, schedule an appointment with your provider.
m If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to have your blood pressure checked more often.
Cholesterol screening
m If you are over age 44, you should be checked every 5 years.
m If you have high cholesterol levels, diabetes, heart disease, kidney problems, or certain other conditions, you may need to be checked more often.
Diabetes screening
m If you are over age 44, you should be screened every 3 years.
m If your blood pressure is above 135/80 mm Hg, or you have other risk factors for diabetes, your provider may test your blood sugar level for diabetes.
Colon cancer screening
If you are under age 50, you should be screened only if you have a strong family history of colon cancer or polyps, or have a history of inflammatory bowel disease or polyps.
If you are between ages 50 - 75, you should be screened for colorectal cancer. This may involve:
m A stool test done every year
m Flexible sigmoidoscopy every 5 - 10 years, along with a stool guaiac test
m Colonoscopy every 10 years
You may need a colonoscopy more often if you have risk factors for colon cancer, such as:
m Ulcerative colitis
m A personal or family history of colorectal cancer
m A history of large colorectal adenomas
Dental exam
m Go to the dentist every year for an exam and cleaning.
Eye exam
m Have an eye exam every 1 - 3 years if you have vision problems or glaucoma risk.
Breast exam
m Women may do a monthly breast self-exam. However, experts do not agree about the benefits of breast self-exams in finding breast cancer or saving lives. Talk to your provider about what is best for you.
m You should contact your provider immediately if you notice a change in your breasts, whether or not you do self-exams.
m Your provider should do a complete breast exam as part of your preventive exam.
Mammogram
m Women ages 40 - 49 may have a mammogram every 1 - 2 years. However, not all experts agree about the benefits of having a mammogram in finding breast cancer or saving lives. Talk to your provider about what is best for you.
m Women ages 50 - 75 should have a mammogram every 1 - 2 years, depending on their risk factors, to check for breast cancer.
Osteoporosis screening
m All postmenopausal women with fractures should have a bone density test (DEXA scan).
m If you are under age 65 and have risk factors for osteoporosis, you should be screened.
Skin exam
m The American Cancer Society recommends a skin exam as part of a periodic exam by your provider, if it is indicated.
Lung cancer screening
The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 55 - 80 years who:
m Have a 30 pack-year smoking history AND
m Currently smoke or have quit within the past 15 years
Health screening: men (Ages 40-64 years)
There are specific times when you should see your provider. Below are screening guidelines for men ages 40-64.
Blood pressure screening
m Have your blood pressure checked every 2 years. If the top number (systolic number) is between 120-139 or the bottom number (diastolic number) is between 80-89mmHg, then have it checked every year.
m If the top number is greater than 140 or the bottom number is greater than 90, schedule an appointment with your provider.
m If you have diabetes, heart disease, kidney problems, or certain other conditions, you may need to have your blood pressure checked more often.
Cholesterol screening and heart disease prevention
m If you are over 34, you should be checked every 5 years.
m If you have high cholesterol levels, diabetes, heart disease, kidney problems, or certain other conditions, you may need to be checked more often.
Diabetes screening
m If you are over 45, you should be screened every 3 years.
m If you are overweight, ask your provider if you should be screened at a younger age.
Colon cancer screening
If you are under 50, you should be screened only if you have a strong family history of colon cancer or polyps, or if you have had inflammatory bowel disease or polyps.
If you are between ages 50-75, you should be screened for colorectal cancer. This may involve:
m A stool test done every year
m Flexible sigmoidoscopy every 5-10 years.
m Colonoscopy every 10 years
You may need a colonoscopy more often if you have risk factors for colon cancer, such as:
m Ulcerative colitis
m A personal or family history of colorectal cancer
m A history of large colorectal adenomas
Prostate cancer screening
m Most men aged 50 or more should discuss screening for prostate cancer with their provider.
m If you choose to be tested, the PSA (Prostatic Specific Antigen) blood test is most often done every year.
Both men & women
m Go to the dentist every year for an exam and cleaning.
m Have an eye exam every 1-3 years if you have vision problems or glaucoma risk.
m If you are between ages 50-70 and have risk factors for osteoporosis, you should discuss screening with your provider.
m Risk factors can include long-term steroid use, low body weight, smoking, heavy alcohol use, or a family history of osteoporosis.
m You should have a preventive health visit every 2 years until age 50, and then once a year.
m Routine diagnostic tests are not recommended.
m Your height, weight, and body mass index (BMI) should be checked at every exam.
During your exam, your provider may ask you about: Depression, diet and exercise, alcohol and tobacco use. You should visit your health care provider regularly, even if you feel healthy. These visits can help you avoid problems in the future and encourage a healthy lifestyle.
Dr Nazma Akter is Resident Physician, Department of Medicine, MARKS Medical College & Hospital, Mirpur-14, Dhaka. Email: [email protected]