7 Life-Saving Tests Every Woman Needs
The pink ribbons, races and charity events that come around every October have one primary goal: to improve early detection of breast cancer. Why? The sooner the disease is caught, the greater chance one has of surviving it.
As science and medicine have advanced over the last several decades, diagnostic tests have improved – making it possible to identify and treat many conditions before they become life-threatening. Unfortunately, many women fail to take the simple steps needed to safeguard their health.
So, in honor of Breast Cancer Awareness Month, and women of all ages, shapes, and sizes, I’ve put together the health assessments and tests every woman—yes, YOU—should be getting at each stage of life. Print it out, tuck it into your planner, and email this list to all the women in your life that you care about. It could very easily save a life.
In your 20’s and 30’s…
• At about age 20, women with increased cardiovascular risk factors, such as a strong family history or current obesity, and about age 45 for those without increased risk, should have a complete fasting lipid profile performed every five years. If you have a lipid imbalance; e.g., high cholesterol or triglycerides, your doctor may require this test to be done more frequently in order to monitor the effects of lifestyle interventions such as diet and exercise and to make sure the problem isn’t getting worse
• In addition, all women with blood pressure above 135/80 should receive a fasting plasma glucose test to screen for diabetes. This is a routine blood test. Frequency of repeat testing is based on baseline values and other health indices such as body mass index and family history. There is a staggering 10 million or so cases of Type 2 diabetes in U.S. women ages 20 and older. This is a largely avoidable disease, and lifestyle interventions can make a big impact, particularly during early and pre-clinical stages. Early or “pre-diabetic” results can allow you to change lifestyle variables or even start medication if necessary. The long term complications of diabetes are far reaching (organ damage, neuropathy, even blindness) so getting it under control early is important.
• Cervical Cancer Screening
Starting at age 21, or within three years of the onset of sexual activity, every woman should have a Pap smear every three years. Early detection of cervical cancer can often be taken care of with a simple procedure whereas later on the woman may need major surgery. Pap smears are not necessary after age 70 if three or more Pap smears in a row have been normal, if there have been no abnormal Pap smears within the past ten years, and if the woman is not at high risk.
In your 40’s and 50’s…
• Starting at age 40, all women should have a comprehensive physical examination, including a detailed family medical history, all basic lab tests, a blood pressure check, and a review of potential risk factors. At our Center, the Preventive Health Exam starts with a detailed questionnaire about overall physical functioning, previous and current medical problems, family history, lifestyle, and health goals. For our readers, I suggest you think about all of these domains of life and jot down some notes before seeing your doctor. It can also be helpful to know about the basic preventive health tests in advance of your appointment, so you can discuss any questions or concerns. During the physical exam, height and weight should be taken and a body mass index (BMI) should be established. The BMI score is a predictor of several health problems, and it is modifiable with diet and lifestyle. The basic preventive health exam should be repeated at least every three years until age 50.
• Starting at age 50, the preventive health exam should be done every two years.
• Breast Cancer Screening
Starting at age 50 until age 75, all women should do a biennial mammogram, according to the U.S. Preventive Services Task Force. We advise earlier (i.e., age 40) and/or yearly mammograms if there are individual patient characteristics that warrant doing so. For example, an annual mammogram is especially important if there is a strong family history or use of Hormone Replacement Therapy (HRT).
• Colon Cancer Screen
Starting at age 50 until age 75, all women should have a colonoscopy every three to five years. This is an outpatient procedure, and the doctor performing it can even remove precancerous polyps as part of the test. Like all cancers, early detection can make all the difference in the world in terms of beating the disease.
• Osteoporosis Screening
Starting at age 50, all women should have a baseline DEXA bone density test. If the woman is not at high risk for osteoporosis, the test can be repeated every few years at her physician’s discretion. If she is at high risk for fractures, the test should be repeated more often. As many as 8 million U.S. women have Osteoporosis, and early interventions can make a big difference on long-term health outcomes.
65 and beyond…
In addition to the above preventive exams and disease screens, there are a couple of additional recommendations for women 65 and older.
• After age 65, vision and hearing should be checked annually as part of the exam.
• By age 65, the comprehensive physical exam should be done annually.
These guidelines are a good starting point, though individual risk factors for other problems are important to consider with your doctor. Be proactive in getting the health care you need- you know your body, your medical and family histories, and your lifestyle better than anyone. It’s vital to share as much information as possible with your physician during routine visits to assure that the preventive health protocol designed for you is as comprehensive and as personalized as possible.
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Dr. Monti is Director of the Myrna Brind Center of Integrative Medicine at Thomas Jefferson University Hospital and the author of “The Great Life Makeover”. Read more about him here.