Do you know what screening tests you need?

Screening tests are an important part of your preventive health care. These tests are used for early detection of some of the more common and potentially deadly diseases—such as cancers, diabetes, and heart disease—that begin to affect people in their middle years. These tests can help catch certain illnesses and conditions in their earliest and most curable stages, even before you notice symptoms. With information from screening tests, your healthcare provider can work with you to develop preventive measures that will improve your health and can even extend your healthy years.

The sections below provide information on the screening tests suggested for adults.

High Blood Pressure

· The 2017 American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines recommends annual screening for adults with blood pressure less than 120/80 mm Hg.

· If you have higher blood pressure and are otherwise at low risk for cardiovascular disease, the guidelines recommend re-screening in 3-6 months after the initial high reading.

· If you have hypertension, and are at high risk for cardiovascular disease, more frequent screenings are necessary, according to your heart disease risk and your blood pressure readings.

High Cholesterol

· The American Heart Association recommends that all adults 20 years of age and older have cholesterol testing (a fasting lipid profile) every 4-6 years. More frequent testing is recommended for those at increased risk.

Diabetes

· The American Diabetes Association (ADA) and the U.S. Preventive Services Task Force (USPSTF) recommend the following:

· If you are age 45 or older, you should be screened.

· If you are younger than 45 but overweight or have any of the other risk factors, consider diabetes screening.

· Even if initial screening results are normal, get repeat testing at least every 3 years, say the ADA and USPSTF. If you are identified as having prediabetes, get tested yearly.

Breast Cancer

Examples of Risk Factors Include:

1. Family history and genetics

2. A personal history of breast cancer

3. Obesity

4. Beginning your period at a younger age

5. Having your first child after age 35

6. Never giving birth

7. Postmenopausal hormone therapy

8. Beginning menopause at an older age

9. Alcohol consumption

Recommendations for average-risk women (women with no risk factors):

Clinical Breast Exams

· The American College of Obstetricians and Gynecologists (ACOG) and the National Comprehensive Cancer Network (NCCN) say women may be offered a clinical breast exam by a healthcare professional every 1 to 3 years for women ages 25 to 39 as part of their regular health exam and annually for women age 40 and older. Women ages 25 and up should be doing self-breast exams monthly!

· The American Cancer Society (ACS) says that women aged 40 to 44 have the option to begin breast cancer screening with mammograms and recommends that women aged 45 to 54 have a mammogram every year.

Recommendations for women with Increased Risk:

· ACS recommends that women at high lifetime risk be screened with magnetic resonance imaging (MRI) in addition to mammography annually beginning at age 30 and continuing as long as they are in good health.

· Women ages 25 and up should be doing self-breast exams monthly!

Some of the important factors contributing to a high lifetime risk include:

1. Carrying a mutated BRCA1 or BRCA2 gene or having a close relative with the gene.

2. Having had chest radiation at a young age (between 10 and 30 years old).

3. Certain family histories, such as multiple close relatives with breast or ovarian cancer.

If you suspect you are at an increased risk for breast cancer, you should consult your healthcare provider and consider developing an individualized screening program.

Cervical Cancer

The American College of Obstetricians and Gynecologists (ACOG), the U.S. Preventive Services Task Force (USPSTF), and the American Cancer Society (ACS) currently recommend that women aged 30 to 65 should have both a Pap test and an HPV DNA test every 5 years (preferable); a Pap test alone every 3 years is also acceptable.

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Colon Cancer

The ACS recommends that people with no known risk factors other than age, begin screening at age 45.

Examples of risk factors include:

1. Risk of colon cancer increases with age

2. Being overweight or obese

3. Occurrence of cancers in other parts of the body

4. Family history—having one or more family members with colon cancer or multiple polyps, especially if they were younger than age 60 at diagnosis

5. Diet—high fat and meat diets are risk factors, especially combined with not eating enough fruits, vegetables, and/or high-fiber foods

6. Lifestyle—these risk factors include cigarette smoking, drinking excessive amounts of alcohol, and lack of regular exercise

7. Having ulcerative colitis, a form of inflammatory bowel disease

8. Having type 2 diabetes

9. Racial or ethnic background—African Americans and Ashkenazi Jews have higher risk and rates of colon cancer compared to others.

· People with increased or high risk of colon cancer may be advised to start screening at a younger age (e.g. age 40). A colonoscopy is usually recommended because it is the most accurate and thorough. Also, the recommended screening interval for high-risk individuals is shorter than for people with average risk (such as every 1-2 years compared to every 10 years).

· Additionally, people who have been screened and found to have colon cancer or high risk pre-cancerous polyps also need more frequent re-testing, usually at least every 3 years. (This is called surveillance.)

Prostate Cancer

· The American Cancer Society (ACS) recommends that healthy men with average risk who wish to be screened consider waiting to get tested until age 50. ACS recommends considering earlier testing for higher-risk groups.

· If you are African American or have a father or brother who was diagnosed before they were 65, ACS recommends considering testing at 45 years of age.

· If more than one relative was affected at a young age, you could begin testing at 40 years old; then, depending on the results, get tested again at age 45 or earlier as results warrant.

· ACS recommends re-screening every two years if your PSA level is less than 2.5 ng/mL and annual screening if it is 2.5 ng/mL or higher.

Tests:

1. Prostate specific antigen (PSA)—blood test that measures the level of PSA in the blood

2. Digital rectal exam (DRE)—part of a physical exam that the health practitioner performs to examine the prostate gland