Health tests at every age
From blood pressure to bone density, our yearly checkups change as we get older. Here's your guide to health tests at every ageBy Lesley Young
While your risk of disease may multiply alongside the number of candles on your cake, the good news is that simple screening tests can help your doctor catch the most common culprits early (and ensure the best possible outcome). According to Dr. Jonathan Kerr, a family physician at Belleville Queen’s University Family Medicine Centre in Belleville, Ont., these are the tests you need to be screened for depending on your age.
Health tests for all ages
• Body Mass Index (BMI) exam. An unhealthy BMI, a rough measure of your body fat based on your height and weight, can occur at any age. The annual physical for children and adults is a great time to gauge BMI, and take measures to improve it if necessary, says Kerr. "Maintaining a healthy weight is a huge preventive measure against conditions such as high blood pressure, that can lead to heart disease and certain cancers, even in kids." To measure your BMI, check out our BMI calculator.
• Blood pressure test. We should all be tested for high blood pressure (HBP) at our annual physical, according to Kerr. This includes children, especially if they are overweight or obese. Obesity is not the only cause of HBP, other triggers include genetics, hormonal abnormalities, hypothyroidism and kidney problems. Often, there are no symptoms of HBP. Left uncontrolled, it increases your risk of serious health problems, including heart attack and stroke, even in children.
• Skin cancer exam. At your annual physical, your doctor will check your entire body for abnormalities or changes in skin lesions and moles that could be signs of skin cancer. "Young patients especially, because they face a higher risk of skin cancer during their lifetime, need to be screened," says Kerr.
Health tests in your 20s
• Women: Pap smear. A pap smear, which tests a swab of cells taken from the cervix opening during a manual exam for cervical cancer, is recommended for women between the age of 18 and 70 every one to two years. Women sexually active before the age of 18 should get the test starting one year after their first encounter, according to Kerr. "Every two years is reasonable for a woman in her 30s and 40s who is with a stable partner. If you are younger and have multiple sexual partners, once a year is better because cervical cancer is caused by the spread of HPV (human papillomavirus), a sexually transmitted disease that can be contracted even when using a condom," explains Kerr. Regular pap smears should continue into your 60s.
Health tests in your 40s
• Women: Mammogram. Women with a family history of breast cancer should begin getting mammograms—an x-ray used to detect masses that could be malignant—every two years at the age of 40, says Kerr. In addition, your doctor should be conducting physical breast exam to feel for abnormalities during your annual visit. If you do not have a family history of breast cancer, regular mammograms should begin at 50.
Health tests in your 50s
• Men and women: Colonoscopy, sigmoidoscopy or fecal occult blood test (FOBT). Both men and women should start being screened for colon cancer with one of these methods every year, starting at the age of 50 (unless there is a family history, in which case exams should start at age 40). People have a few options, according to Kerr.
In a colonoscopy—which Kerr recommends having once every ten years—a tiny camera is inserted the colon to look for cancerous growths. "It’s uncomfortable, but a very good test," says Kerr. A sigmoidoscopy is similar, except only the lower third of the colon is examined for growths. "Sometimes that’s all that’s possible in people where it is harder to get higher up." A sigmoidoscopy should be done every three years. A fecal occult blood test (FOBT) can be done in the privacy of your own home (you mail a sample of your feces to a lab). "That smear is tested for blood in the stool. If there is blood, then you go for a colonoscopy," explains Kerr. An FOBT should be done on a yearly basis.
• Men and women: Fasting glucose (blood) test. Starting at the age of 50, men and women should be screened for type 2 diabetes annually with a fasting glucose test (a simple blood test that can be done during your annual physical). Kerr says that this test should be conducted at any age if the patient is obese, even a little overweight, or has a family history of diabetes. Type 2 diabetes is a chronic condition wherein your body is resistant to insulin or doesn’t produce enough to maintain consistent glucose levels. If left untreated, type 2 diabetes can be life-threatening.
• Men and women: High cholesterol (blood) test. Dr. Kerr recommends cholesterol levels be tested annually at age 50, or any age where there is family history of high cholesterol, heart disease or if the person is overweight. This blood test requires that you refrain from eating or drinking anything but water for eight hours prior.
• Men: Prostate exam and/or prostate-special antigen (PSA) (blood) test. When men turn 50, they should get a physical and/or PSA blood test to check for prostate cancer every one to two years, says Kerr. Some men absolutely refuse to have a physical exam because they are uncomfortable about having a finger inserted into their rectum (to check for knobs or bumps on the prostate), says Kerr. In this case, they can get the PSA blood test, and if levels of the prostate-special antigen are elevated, further tests would be conducted to determine whether prostate cancer is at play. "It’s definitely more reliable to have both done," adds Kerr.
Health tests when you're 60+
• Men and women: Glaucoma. There are currently no defined criteria for screening for glaucoma. a group of eye conditions that result in optic nerve damage from abnormally high pressure inside your eye, says Kerr. "The biggest problem is that the natural course of glaucoma is not fully understood. Why do some people get it and others do not? Certainly screening everyone for glaucoma given our current tests would not be cost-effective." That being said, he adds, it is generally agreed that people should see optometrists every two years for a full eye exam, especially if they are in the high-risk groups for glaucoma: from African or Hispanic ancestry, have a family history of glaucoma, have diabetes, or are near-sighted (i.e. far away objects seem blurry). Kerr notes that those in high-risk groups should start glaucoma exams at age 50.
• Men and women: Bone density test. Everyone over the age of 65 should have a bone mineral density test to check for risk of fracture, says Kerr. "A lot of men think they are not at risk for osteoporosis," he says. "They are, and they need this exam, too." He adds that a bone density test may need to be conducted earlier if a person is thin or frail and/or a smoker.
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Web exclusive, September 2010