In addition to ferrying our kids to their activities, we keep running between work, the gym, and the grocery store. And chances are good that your car gets a tune-up more often than you do. While many doctors send a friendly reminder when it is time for a periodic physical, some of us are on our own to remember when it is time for our next "30,000 mile" tune-up.
It pays to pay attention. All of the medical procedures described below are proactive rather than reactive. Each is designed to catch a developing health problem in its early, more treatable stages. As such, timing is everything, so it is in every woman's best interest to become an informed healthcare consumer. Keep in mind that the timetable suggested for each test applies to healthy women. If you have specific medical concerns, follow the guidance of your doctor.
Guarding Against Cancer
is a screening device that is used to identify a cancerous lump in its early stages. There is controversy about when women who are at low risk for developing breast cancer should start to have periodic mammograms, but many organizations suggest that screening or at least discussion about screening should start at age 40. The United States Preventive Services Task Force (USPSTF) is one organization that provides guidelines for breast cancer screening.
If you are interested in getting a mammogram, you should be able to find a certified facility through your doctor. Insurance usually covers the procedure. The National Cancer Institute's Cancer Information Service (1-800-422-6237) can also provide a list of certified facilities, answer related questions, and make referrals for free or low cost mammograms if you are uninsured or underinsured.
Risk of developing colon cancer increases with age, so it is important for to learn the facts about this disease and know about tests that can help you detect it. Although often perceived as a "man's disease," it is one of the most common types of cancer in women. As is the case with any type of cancer, early detection is the key to survival.
While there are many organizations that offer guidelines for colon cancer, the most common recommendations for people aged 50 years and older include:
Fecal occult blood test (detects blood in the stool)—every year
Sigmoidoscopy—visual exam of the rectum and lower portion of the colon, every five years, or
Colonoscopy (visual exam of the rectum and entire colon) every 10 years, or
Barium enema (x-rays of the lower intestines using barium)—every 5 years, or
Computed tomographic colonography (computer that uses x-rays to make a picture of your intestines) every 5 years.
A Pap test
is used to identify cervical cancer before symptoms become apparent. As part of the test, cells scraped from the cervix are smeared on a slide and examined under a microscope for any unusual looking cells. Suspect cells identified during this procedure indicate the need for further testing.
The American College of Obstetricians and Gynecologists recommends the following guidelines for cervical cancer screening:
If you are aged 21-29 years—It is recommended that you have the Pap test every two years.
If you are aged 30 or older—It is recommended that you have the Pap test every three years.
If you are aged 65 or older—You may be able to stop having Pap tests if you have had three normal results in a row and no abnormal results in the past 10 years.
Note: You will need to have Pap tests done more often if you have abnormal results or certain conditions, such as:
A sexually transmitted virus called the human papilloma virus (HPV) can cause changes in cervical cells. In some cases, these changes can lead to cancer. The HPV test, which is used along with the Pap test, screens women for the HPV virus. The same cervical sample taken for the Pap test can be tested for HPV. The test is usually used in women aged 30 and older.
Heart Disease Is a Women's Problem Too
It is actually the most potent health risk for both men and women in the United States. A lipid profile that includes a measurement of total cholesterol, HDL "good" cholesterol, LDL "bad" cholesterol, and triglycerides is an important part of your preventive healthcare. As with other conditions, organizations vary in their screening guidelines. The USPSTF recommends routine cholesterol testing in women aged 45 years and older. But, if you are at an increased risk of heart disease, screening starts at age 20. And since high blood pressure is a risk factor for heart disease, USPSTF also suggests that all women (starting at age 18) get their blood pressure checked as part of routine medical care.
Other Tests You May Need
Depending on your age and risk factors, your doctor may also screen you for:
Osteoporosis—If you are 65 years or older, the USPSTF recommends that you get screened for osteoporosis. Screening involves a bone mineral density test. This is a noninvasive way to measure bone mass. If you have risk factors for osteoporosis, screening should begin earlier.
Type 2 diabetes—According to the USPSTF, you should be screened for diabetes if your blood pressure is above 135/80 mmHg. But, the American Diabetes Association recommends screening in all adults aged 45 years and older. If you are overweight or obese with other risk factors (like a family history of diabetes or high cholesterol), screening is done at any age.
Sexually transmitted diseases—If you are aged 25 years or younger, the USPSTF recommends screening for chlamydia and gonorrhea. If you are at high risk (eg, having multiple partners, having a new partner, not using condoms), you should be screened at any age for chlamydia, gonorrhea, syphilis, and HIV.
You and your doctor can work together to create a screening schedule that is right for you.
DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed/what.php: American College of Obstetricians and Gynecologists. Practice bulletin #109: cervical cytology screening. Obstet Gynecol. 2009;114(6):1409.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a