What does appropriate healthcare look like? This is a fraught question, and one that even people with good insurance and positive relationships with their primary care physicians may struggle with. In particular, there is a lot of debate about preventative healthcare and disease screenings, with an increasing number of these tests recommended each year, especially for older adults. Testing norms seem to change all the time and sometimes it can be unclear which tests are really important.
If you’re concerned about what tests you need and how often you should be examined for signs of disease, there are a number of ways to address the problem – starting with having an honest conversation with your doctor. However, there are also a number of tests that you should never skip, with these four at the top of the list.
Colonoscopy – Find Your Baseline
Colonoscopies are infamous for being the sort of test that people try to avoid, but the good news is that if you’re otherwise healthy, you won’t need many of them over the course of your lifetime. Instead, beginning at age 50 you should have a baseline colon cancer screening. This is often a colonoscopy, but for those with minimal risk factors, it may also be a flexible sigmoidoscopy or certain types of fecal tests. Then, if you have a clear test at age 50, you can wait another 10 years for a retest; if your doctor finds and removes a few small adenomas – a common finding, you’ll need to come back for another round of testing in five years.
Mammograms – An Annual Check
Mammograms are one of the most widely debated tests among medical professionals, and while the general consensus is that women should have annual mammograms beginning at age 40, some do believe that we are currently over-screening, leading to false positives and unnecessary tests. In general, though, the consensus is that it’s better to be safe than sorry, and that regular mammograms help catch breast cancer early, driving up survival rates.
As with other major screening tests, you may need to begin undergoing mammograms sooner if you have a high risk of breast cancer. This includes women with a strong family history of early breast cancer, particularly those who are positive for either the BRCA 1 or BRCA 2 mutations. There are also a number of other genetic conditions that can increase cancer risk, such as Lynch Syndrome and Cowden’s Syndrome.
Pap Smear – An Every Third Year Routine
Pap smears are the best tool we have for detecting uterine cancer, and it’s generally recommended that women begin undergoing them at age 18 or when they become sexually active, whichever comes first. After that, as long as testing is normal, pap smears are usually repeated every three years to check for abnormal cells, and annually if the prior test was abnormal.
Because pap smear recommendations start with relatively young women, the average woman will undergo many of them in her lifetime. After age 65, however, most doctors allow women to have a pap smear every 10 years if they have had three normal tests in the past decade.
Diabetes Screening – Not For Everyone
Type 2 diabetes cases have been on the rise for many years now, but we have a good sense of what can increase a person’s risk. Based on that information, the standard guideline is to perform an annual type 2 diabetes screening for all adults ages 40 to 70 who are overweight or obese, as well as those on certain medications.
One advantage of annual type 2 diabetes screenings is that it can help identify individuals classified as prediabetic. Individuals with prediabetes may never develop diabetes, particularly if they are able to make effective lifestyle changes during this time. By catching early indicators, doctors can help their patients prevent much more serious issues, including neuropathy and gastroparesis, that may be caused by poorly controlled diabetes.
There are hundreds of medical tests available today, of varying value, accuracy, and importance. While these four represent just the tip of the iceberg, it’s important to follow the associated testing guidelines for optimal health. Early detection saves lives and improves quality of life – and that is the goal of each of these tests.
