6 health screenings that are more important as you age
Preventive testing is key to healthy aging. Here are the cancer and cardiovascular screenings you should consider.
Early screening tests for common and potentially fatal diseases are an important part of preventive health care.
Through them, physicians can discover illnesses or conditions in their earliest and most curable stages — often before symptoms appear.
Consult your health care provider regarding appropriate timing and frequency of available screening tests, because there are many variables.
“It really depends on each individual patient as there are different screenings that are appropriate for different age groups and genders,” says Emily Grewe-Nelson, D.O., a local family medicine doctor in the Hillcrest network. A yearly wellness exam allows your physician to discuss any needed health screenings.
Regular screenings include but are not limited to blood pressure, cholesterol, certain types of cancer, diabetes, depression, dementia and heart disease. Dental and vision exams also are an important component of preventative health care.
Guidelines for these screenings can vary. However many medical organizations cite the U.S. Preventive Services Task Force (USPSTF) as the benchmark. Created in 1984, this group consists of 16 volunteer individuals who are nationally recognized experts in prevention, primary care and evidence-based medicine.
“At Warren Clinic, we generally adhere to evidence-based guidelines for what services to provide,” says Lance King, M.D., medical director of Warren Clinic. “A published guide of recommendations from the most authoritative group can be found on the USPSTF website (uspreventiveservicestaskforce.org).”
Cardiovascular disease is the leading cause of death in both men and women in the U.S., according to the United Health Foundation.
Cardiovascular deaths result from heart disease, stroke, high blood pressure, heart attack and heart failure. Cardiovascular disease is treatable and can often be prevented by healthy lifestyle changes if caught early enough.
The Cardiac Calcium Score is the most important evidence-based test, says Richard D. Kacere, M.D., a cardiologist at St. John Medical Center. “This scan has been shown to have increased prognostic value over and above traditional risk factors for cardiac disease.”
The screening exam uses computed tomography (CT) technology to easily ascertain the amount of calcium build-up in the coronary arteries, he says. It does not require an IV or X-ray dye, and results can be obtained in a matter of seconds.
“It is reasonable for an asymptomatic patient between the ages of 50-75 years old to get a Cardiac Calcium Score to help define their risk of future cardiac events,” Kacere says.
If you’ve ever had a checkup at the doctor’s office, you’re familiar with the arm cuff and pump that provides an irritating squeeze and awkward silence while waiting for the results. Uncomfortable moments aside, the importance of this test cannot be understated.
One in three American adults has high blood pressure, according to the Centers for Disease Control and Prevention. Unfortunately, high blood pressure often has no symptoms, which means routine testing is critical. Often called “the silent killer,” high blood pressure can lead to serious health problems including stroke and heart disease.
“If you’re looking for a basic screening that almost everyone needs,” Grewe-Nelson says, “a blood pressure screening once a year is recommended for men and women.”
People aged 40 and older, or with higher risk factors, should get their blood pressure checked annually, according to the Preventive Services Task Force. Risk factors include, but are not limited to obesity, alcohol abuse, unhealthy diet, sedentary lifestyle and African-American ethnicity.
Always included in your annual wellness exam, the blood pressure test measures how hard your heart is working to pump blood through your body. Two numbers are measured, the first (systolic) is the pressure in your arteries when your heart beats, the second (diastolic) is the pressure in your arteries between beats.
The American Heart Association defines normal blood pressure to be 120/80 or lower, and as of a 2017 report in conjunction with the American College of Cardiology, high blood pressure is defined as 130/80 or higher.
Unlike other screenings, self-testing can also be done at machines in pharmacies, some grocery stores and home monitoring machines.
Similar to high blood pressure, people with high cholesterol don’t have signs or symptoms initially. A blood test is the only way to detect it.
Unfortunately, too much cholesterol in the blood vessels can build up and impede blood flow, which can lead to heart disease, heart attack or stroke.
The American Heart Association states that “hyperlipidemia means your blood has too many lipids (or fats), such as cholesterol and triglycerides. One type of hyperlipidemia — hypercholesterolemia — means there’s too much LDL (bad) cholesterol in your blood. This condition increases fatty deposits in arteries and the risk of blockages.”
Often poor diet is the biggest contributing factor, and with proper lifestyle changes cholesterol can return to a healthy range.
According to the Dept. of Health and Human Services, cholesterol can be checked with a blood test called a lipid profile. The results will show four numbers, which include total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides.
Consult your doctor about pre-test preparation, because fasting may be required for nine to 12 hours prior to the test.
The CDC recommends adults without heart disease have cholesterol checked every four to six years. Those with heart disease should consult their physician about routine screenings.
Risk factors include diabetes, family history of cardiovascular disease, tobacco use, high blood pressure, obesity and sedentary lifestyle.
Like all screenings, it is important to discuss a plan with your physician because recommendations for the age of first screening vary. Retesting is usually performed every five years.
Cancer is a complex group of diseases with many possible causes, according to the American Cancer Society. USPSTF claims that screenings leading to early detection of lung, colorectal and breast cancers lends to better treatment and recovery.
“Nearly 50 percent of cancers can be prevented through lifestyle changes such as smoking cessation and maintaining a healthy weight,” says Kevin Tulipana, D.O., director of hospital medicine and vice chief of staff at Cancer Treatment Centers of America in Tulsa.
“Because prevention cannot stop everything, screening for health problems is extremely important,” he says.
Approximately 85 percent of lung cancer cases are due to smoking, according to the Preventive Services Task Force. Although the prevalence of smoking has decreased over the years, approximately 37 percent of U.S. adults are current or former smokers, its data says. The percentage of Oklahomans age 18-44 who smoke is 22.6 percent compared to 18.1 nationally.
Tulipana explains that when lung cancer is found early it is potentially curable; unfortunately, if it has grown past a local stage the survival rates decline rapidly.
“Annual lung cancer screening with a CT scan is the only screening method proven to reduce mortality related to lung cancer by almost 20 percent,” he says.
The USPSTF recommends annual screening for lung cancer in adults 55 to 80 years of age who have a 30 pack-year smoking history and currently smoke or quit within the past 15 years.
Their guidelines define “30 pack-year” as someone who has smoked a pack a day for at least 30 years. Other risk factors include family history, radon exposure, specific occupational exposures and history of chronic obstructive lung disease.
“Colon cancer is the third most commonly diagnosed malignancy,” Tulipana says. “Generally, people should consider beginning colorectal cancer screening at 50 years of age, but certain high-risk individuals should start much earlier. It is best to talk with your doctor about these risks and your family history to determine when to begin colorectal cancer screening.”
The USPSTF recommends routine colon cancer screening for adults aged 50-75. Those 76-85 should make an individual decision based on overall health and prior screenings.
Risk factors include but are not limited to family history of colorectal cancer, polyps in the colon, obesity, smoking, alcohol abuse, sedentary lifestyle and Crohn’s disease.
Early detection is crucial because colorectal cancer can spread to other parts of the body.
The most common types of screening are stool-based tests or tests that look directly inside the colon and rectum. “The generally acceptable tests include high-sensitivity fecal occult blood identification, stool DNA testing, sigmoidoscopy and colonoscopy,” Tulipana says.
Frequency depends on the screening method used. A colonoscopy can possibly be done every 10 years. However, stool-based testing for microscopic blood requires annual testing.
More than 40,000 women die from breast cancer every year, according to the Centers for Disease Control. It is the second most common cancer among women behind skin cancer. Regular screening can detect tumors at an early stage when they are most treatable.
Screening consists of clinical exams or a mammogram, which is an X-ray of the breast. The mammogram is considered the best way to detect breast cancer.
The USPSTF recommends women who are 50-74 years of age and are considered average risk for breast cancer should get a mammogram every two years.
The American College of Obstetricians and Gynecologists (ACOG) recommends a breast exam by a professional every one to three years for those 25-39 and annually for women 40 and older as part of a regular health exam.
“As with all other screening recommendations, there are specific populations who should undergo screening starting at an earlier age or using different modalities,” Tulipana says. “If you have a significant family history of breast cancer or other cancer, please talk with your doctor about the options.”
Aside from family history, risk factors for breast cancer also include obesity, postmenopausal hormone therapy, alcohol consumption, having your first child after 35 or never giving birth.
Those with higher risk factors may have a test called breast magnetic resonance imaging (MRI). The breast MRI uses magnetics and radio waves to take photos of the breast.
According to the Centers for Disease Control, breast MRIs may appear abnormal even when there is no cancer, so they are not used for women at average risk.
Although medical tests can be expensive, the Affordable Care Act requires most insurance plans to cover a number of screening tests. This means these screenings might be performed at no cost to the patient. The USPSTF encourages individuals to check with their insurance provider about coverage.