That old saying “an ounce of prevention is worth a pound of cure” has probably never been more true when it comes to your personal health. Decades of studies show that simple screening tests performed at regular intervals, as well as regular check-ups and patient counseling, can keep people healthy by catching problems early, when they’re most easily cured.
In fact, if everyone in America adhered to the recommendations for screening tests—such as cholesterol tests or mammograms—an estimated 100,000 lives could be saved each year, according to the Centers for Disease Control and Prevention (CDC). Moreover, under the Affordable Care Act, most preventive healthcare is now free, with no copays or deductibles.
According to the CDC, “A screening test is used to look for a disease when a person doesn’t have symptoms. (When a person has symptoms, diagnostic tests are used to find out the cause of the symptoms.)” What tests to get and when to get them depends on your gender, age, and also some other personalized risk factors.
But Americans aren’t very good about getting the recommended screening tests. For example, last year, the CDC reported that only about 80 percent of women got screened for cervical cancer and 72 percent for breast cancer. Fewer than 60 percent of Americans get their recommended screening for colorectal cancer. So why don’t more people adhere to preventive health guidelines? It may be because some tests cause false positives and lead to further tests or unnecessary treatments. Also, some tests involve small risks, such as exposure to radiation.
However, Celeste Robb-Nicholson, MD, associate professor of medicine at Massachusetts General Hospital, reports that routine X-ray screenings (such as dental X-rays or mammograms) have very little risk. Experts are more concerned with screenings like CT or nuclear imaging tests that give a higher dose of radiation. “The benefits of these tests, when they’re appropriate, far outweigh any radiation-associated cancer risks,” Robb-Nicholson notes. “The risk from a single CT scan or nuclear imaging test is quite small.”
Moreover, guidelines on screenings sometimes change, or professional medical organizations publish slightly differing recommendations, leaving consumers confused. Discuss your concerns with your doctor to arrive at the best decision for you. Choosing Wisely has a helpful website on weighing the pros and cons of screening.
Screening guidelines are evolving from “one size fits all” to a more personalized approach. For example, the guidelines for breast cancer screening were recently changed to give women under 50 and their doctors more flexibility to personalize screening according to risk factors. While a mammogram is recommended every two years for women 50-74, those under 50 who display potential risk factors may start mammograms earlier.
That’s why it’s more important than ever to have your annual wellness check and discuss what tests you need with your physician. Electronic health records make it easier than ever to keep track of what tests you’ve had and when you’re due for others. If you’re unsure, pick up the phone and call your doctor’s office.
Preventive care doesn’t just include screening tests. During wellness checks, you can get necessary immunizations and talk to your doctor about dealing with smoking, weight problems, nutrition and dieting, use of aspirin to prevent heart attack and stroke, exercise guidelines, how to prevent falls, and other issues that will help lower your risk for serious disease.
Here’s a guide to screening tests that adults are expected to take:
Aortic aneurysm—if you’re a man with a history of smoking, talk with your doctor about abdominal aortic aneurysm. A one-time ultrasound test is recommended for men ages 65 to 75 who have ever smoked tobacco.
Blood Pressure—blood pressure levels should be tested at least every two years. Talk to your doctor to find out whether you need more regular testing.
Cholesterol—men 35 and up, as well as people at high risk over 20, should have their cholesterol checked at least every five years.
Colorectal cancer—adults 50 to 75 should be screened at regular intervals for colorectal cancer, and older adults should talk with their physician to find out whether they should be tested. People may need to be tested earlier or more frequently than others if they meet the following conditions:
- History of colorectal cancer or polyps in the individual or their family
- Inflammatory bowel disease, Crohn’s disease, or ulcerative colitis
- Certain genetic syndromes, such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome)
Sexually transmitted diseases—your doctor can help you determine whether you should be screened for diseases such as chlamydia, gonorrhea, or syphilis. Adults with risk factors or who are sexually active should usually be tested.
Diabetes—ask your doctor about screening for type 2 diabetes if you have a history of high blood pressure. Overweight adults age 40-70 should be screened for abnormal blood glucose.
Hepatitis C—hepatitis C can be “silent,” with no symptoms. That’s why it’s important to get tested for hepatitis C at least one time if you were born between 1945 and 1965. This is the generation of Americans at highest risk for the disease.
HIV—have an HIV test if you are pregnant, or at least once between the ages of 15 and 65. Talk to your doctor about when to have the test. You may need to get tested more often depending on your risk.
Lung cancer—if you currently smoke, have a history of heavy smoking (30 packs a year), or have quit within the past 15 years, talk to your doctor about whether you should be screened for lung cancer. People 55-80 years old who meet these conditions should be screened yearly. Once a person has not smoked for 15 years, screening is no longer needed.
Skin cancer—according to the CDC, “The USPSTF has concluded there is not enough evidence to recommend for or against routine screening (total body examination by a doctor) to find skin cancers early.” If you are fair-skinned, discuss ways to lower your risk of skin cancer with your physician.
Osteoporosis—for women, get your bone density tested starting at age 65. Younger women may also benefit from testing if they are at higher than normal risk for osteoporosis.
Ovarian cancer—women with a family history of breast, ovarian, tubal, or peritoneal cancer should be screened for ovarian cancer. The CA 125 blood test is not recommended for routine screening of ovarian cancer because of poor accuracy.
Breast cancer—women age 50-74 should schedule a mammogram every two years. Women younger than 50 with certain risk factors should talk with their doctor about whether they should start mammograms earlier.
Cervical cancer—women 21-65 should be screened for cervical cancer with a Pap test every three years. After age 30, those who opt for a Pap and HPV test can be screened every five years.