As your 2012 calendar starts to fill, think about making appointments for health screenings you know family members need this year.
“People get busy, and if they feel well, they go about their business thinking they are healthy,” says Glen Stream, president of the American Academy of Family Physicians. “As a country, we have too much focus on illness treatment rather than on wellness and prevention, which leads to people having problems that could be avoided.”
But it’s easy to get confused about what screenings you need, and how often to get them, especially when recommendations change or when different medical groups have conflicting guidelines. Your first step: Find a doctor who can help you sort it all out, suggests Stream. “You really need to have a coordinated plan.”
Miriam Alexander, president of the American College of Preventive Medicine, says the “gold standard” of screening guidelines is set by the U.S. Preventive Services Task Force, an independent panel of experts in preventive and evidence-based medicine. The group makes its population-wide evaluations solely on the basis of scientific evidence to determine if a screening will be more beneficial than harmful to patients, says Virginia Moyer, the group’s chair.
Other groups, such as the American Cancer Society, may differ with the task force on some guidelines, such as the age at which women should start getting mammograms. (ACS recommends most screenings start at 40; the task force at 50). “The task force looks at the evidence from 30,000 feet,” says Alexander, basing them on the population as a whole, not individuals with unique family histories or situations. Weighing all the recommendations along with your personal needs is important. “Sometimes we have to make decisions that are not based on the best scientific evidence, but on what’s best for us,” says Alexander.
Making those personal evaluations with a doctor is even more crucial in the face of new findings, such as recent research from the National Cancer Institute that showed no benefit, and possible harm, from annual PSA screenings for prostate cancer. “We’re all still absorbing these latest studies,” says preventive health physician Deborah Rhodes of the Mayo Clinic’s Executive Health Program.
Rhodes also cautions that an annual physical doesn’t screen for everything, so getting an all-clear from your doctor doesn’t mean you’re bulletproof. Even if you’ve just had a physical the day before, if you notice something strange or have a nagging pain, don’t ignore it. “You have to be proactive,” she says.
Experts agree that the guidelines below should prompt discussion with your doctor and are important tools to help you take control over your health.
CERVICAL CANCER. If you are a woman age 21 to 65 and have been sexually active, the task force strongly recommends screening for cervical cancer with a Pap smear every one to three years. If you are older than 65 and recent Pap smears were normal, you no longer need them. Nor do you need one if you have had a hysterectomy for a reason other than cancer. The American Cancer Society’s guidelines are similar: All women should be screened within three years of becoming sexually active, but no later than 21. Screening is recommended annually with a regular Pap test or every two years using a newer liquid-based Pap. If you’re over 70 and have had three or more normal tests in a row, or haven’t had any abnormal tests in the last 10 years, you don’t need to be screened.
COLORECTAL CANCER. The task force recommends screening using fecal occult blood testing (once a year), sigmoidoscopy (every 5 years) or colonoscopy (every 10 years) in adults, beginning at 50 and continuing until 75. But if you have a family history, consult your doctor about screenings more often.
DIABETES. If your blood pressure (either treated or untreated) is greater than 135/80, the task force recommends you get screened. The American Diabetes Association suggests if you are overweight and over 45, or are younger than 45, overweight and have other risk factors (high blood pressure, family history, a history of gestational diabetes) that you get checked for prediabetes or diabetes at least every three years. “People with type 2 diabetes often are without symptoms for many years,” says Sue Kirkman, senior vice president of medical affairs at the American Diabetes Association. “It’s more treatable when you find it early.”
EYES. Adults should get a baseline eye screening at age 40, which is when diseases and changes in the eye may start to occur, says the American Academy of Ophthalmology. If you have risk factors of eye disease (family history, diabetes, high blood pressure), consult an ophthalmologist to determine how often you should go for checkups.
HEART. The task force recommends a one-time screening for abdominal aortic aneurysm in men 65 to 75 who have ever smoked. This test screens for a bulging in the largest artery in your body; if it bursts, it could be fatal. If you’re 18 or older, get your blood pressure checked every two years, says the task force. While the American Heart Association recommends everyone 20 or older have cholesterol screening every five years, the task force’s guidelines recommend waiting to screen men at 35 and women 45 and older. If you’re at increased risk for heart disease (if you use tobacco, are obese, have diabetes or high blood pressure, have a history of heart disease, or a man in your family has had a heart attack before 50 or a woman before 60), you should be screened starting at age 20, the task force advises.
HIV. The task force strongly recommends that anyone at increased risk for HIV infection be screened. Risks can include unprotected sex with multiple partners, injection drug use, treatment for STDs or sex with a partner with HIV.
MAMMOGRAMS. The task force recommends women 50 to 74 get a mammogram every two years. If you are 40 to 49, the group also advises you to talk to your doctor about when and how often you should be screened. (The American Cancer Society recommends high-quality mammograms begin at 40 and continue as long as you are in good health.) “The complexity of these screening recommendations have increased over time,” says Stream, who advises talking to your physician about customizing your screening plan based on personal risk factors.
OSTEOPOROSIS. Women 65 and older should be screened routinely for osteoporosis; if you are at increased risk for fractures related to bone loss, begin screenings at 60, says the task force. “But it also comes down to common sense,” says Rhodes, who feels there’s a value in doing this test earlier, when you have time to intervene.
PROSTATE. According to the task force, there is not enough evidence to weigh the benefits vs. harms of prostate cancer screening in men younger than 75. However, the American Cancer Society suggests that at 50, men talk to their doctors about the pros and cons and their own personal risk factors. Black men, or men whose father or brother had prostate cancer before 65, should start the conversation at 45. “The fact that screening harms men is clear,” says Otis Brawley, chief medical and scientific officers at the American Cancer Society; more study is necessary to determine how many lives it may save.
SEXUAL HEALTH. If you’re a non-pregnant woman who is sexually active and under age 24, or a woman who is at increased risk, the task force recommends screening for chlamydia. It also recommends anyone at risk for gonorrhea and syphilis be tested for those sexually transmitted diseases.
SKIN CANCER. “There is no set routine schedule,” says Allison Sitt of the American Academy of Dermatology. “But factors like an unusual amount of moles or rapid mole growth is something that everyone should look out for.” If you notice moles that are asymmetrical, have ragged or blurred edges, pigmentation that is not uniform, larger than 6mm in diameter or changes in size, shape or color, talk to your doctor.
DENTAL HEALTH. Schedule an appointment with your dentist at least once a year and replace your toothbrush every three to four months, advises the American Dental Association. “The mouth is a portal to the rest of the body,” says Alice Boghosian, the group’s consumer advice spokesperson. “We can get a general sense of someone’s overall health based on what we see in their mouth.”
VACCINATIONS. They aren’t just for kids. “Immunizations are one of the most important interventions we can do,” says Rhodes. Adult immunizations may include tetanus, diphtheria and pertussis (Tdap), the flu, and zoster, recommended for those who are 60 or older to ward off shingles. Find vaccination guidelines from the Centers for Disease Control and Prevention at cdc.gov/vaccines/recs/schedules.
Source: By Molly Lyons, USA TODAY www.houmatoday.com/article/20120126/WIRE/120129711/1008/living
Comments: Why were we not doing this years ago??? Preventative mendicine is big business now. As the cost of health care continues to soar this is a solution- prevent getting sick in the first place. What a concept! How is that done? The answer is clear and is supported by many of our Major health care agencies like the National Institute of Health (NIH), and other that mentioned in this article who recommend LifesStyle Medicine Strategies through Therapeutic Lifestyle Changes (TLC) as the Firstline!
Molly Lyons thank you.
Dr Pat
