Health Check-Ups for Women
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
A ]]>mammogram]]> 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.
US Department of Health and Human Services
Women's Health Matters
American College of Obstetricians and Gynecologists. First cervical cancer screening delayed until age 21 less frequent Pap tests recommended. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/from_home/publications/press_releases/nr11-20-09.cfm. Published November 20, 2009. Accessed November 23, 2009.
Cervical cancer. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81. Updated September 2009. Accessed March 3, 2010.
Colorectal screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 2010. Accessed March 3, 2010.
Diabetes mellitus type 2 screening. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 2010. Accessed March 3, 2010.
Hypercholesterolemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 2010. Accessed March 3, 2010.
Lipid profile. Lab Tests Online website. Available at: http://www.labtestsonline.org/understanding/analytes/lipid/glance.html. Updated January 4, 2010. Accessed March 3, 2010.
Screening for osteoporosis. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81. Updated September 2009. Accessed March 3, 2010.
Screening for type 2 diabetes. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=15topicID=81. Updated February 2010. Accessed March 3, 2010.
National cholesterol education program. The National Institute of Health. Available at: http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3xsum.pdf. Published 2001. Accessed December 4, 2009.
Osteoporosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated February 2010. Accessed March 3, 2010.
USPSTF recommendations for STI screening. Am Fam Physician. 2008;77(6):819.
What are the key statistics about breast cancer? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_are_the_key_statistics_for_breast_cancer_5.asp?sitearea=. Updated November 18, 2009. Accessed December 4, 2009.
What are the key statistics about cervical cancer? American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_are_the_key_statistics_for_cervical_cancer_8.asp?sitearea=. Updated November 14, 2009. Accessed December 4, 2009.
What you need to know about colon cancer screening. American Cancer Society website. Available at: http://www.cancer.org/docroot/SPC/content/SPC_1_Colon_Cancer_Signs_Symptoms_and_Screening.asp. Updated February 25, 2010. Accessed March 3, 2010.
Women's Health.gov website. Available at: http://www.womenshealth.gov/. Accessed December 4, 2009.
12/4/2009 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.
Last reviewed March 2010 by ]]>Brian Randall, MD]]>
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 medical condition.
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