There has been much debate over the years regarding the value of health maintenance and preventive care. The function of prevention is early diagnosis of a medical condition in order to initiate treatment before the condition progresses to the point of a serious negative impact on the person’s health. Prevention also involves advice from a health care professional regarding negative health habits that promote disease and disability, and suggest positive behaviors to avert such a result.
Researchers have determined that there are five major screening tests worth administering to adults: cholesterol, blood pressure (including height and weight), fecal occult blood testing for colorectal cancer, and mammograms and pap smears in women.
A patient should have an annual health maintenance “check-up” starting at 19 years of age. Self breast exams should start immediately in women, and a baseline mammogram for women should be completed between ages 35-39. From age 40-49, a woman should have a mammogram every two years, unless there is a family history of breast cancer then annually from ages 50-64 with every three years in women over 65.
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A woman should have a pap smear by age 21 or at least three years after becominge sexually active then every 1-3 years at the physician’s discretion. The testing for prostate cancer in men generally starts at age 40 with a digital rectal exam checking the prostate size and for nodules along with a lab test, PSA (Prostatic Specific Antigen). An elevated PSA should be approached with caution as a false positive result may occur in a male without prostate cancer. Further evaluation by a Urologist is warranted.
According to the National Cancer Institute, colorectal cancer is the second leading cause of death in both men and women. It is vital to diagnose colon cancer early as it is much more difficult to treat in its later stages. It is reasonable to start fecal occult blood testing at age 40 with “colon cards” whereby the patient does a home test for blood in the stool and is returned to the doctor for development. The latest recommendations encourage a complete colonoscopy starting every 10 years at age 50, then more frequently if abnormalities are found on the first examination.
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Blood pressure should be checked at every encounter with a patient, and cholesterol should be checked at least every five years. If there is a strong family history of diabetes, fasting blood sugar should be checked routinely at least every three years after age 45. I encourage a baseline bone density exam in women at age 50 due to the high risk of fractures in elderly women.
It is disheartening that two-thirds of Americans do not get an annual physical exam. In an employee program sponsored by the Kodak company in Rochester, N.Y., when screening their female patients, early stage breast cancer cost about $15,000 to treat as opposed to $150,000 for a woman in the later stages of the disease.
Healthy lifestyle habits dictate the direction of one’s medical status in the future. Negative health habits such as smoking are attributed to at least 400,000 preventable deaths annually. Any form of tobacco increases one’s risk of a malignancy. A balanced diet of protein, fruits, vegetables and whole grains leads to better digestive health, weight control and more energy. Regular 30 minutes of cardiovascular exercise at least three times a week is associated with longevity. Excessive alcohol intake increases the risk of heart, liver and stomach ailments and especially in women, more than 1 ounce of alcohol daily is linked to breast cancer. Illegal drugs should be avoided entirely, safe sex is encouraged with the use of condoms to reduce the spread of sexually transmitted diseases, and the wearing of seat belts cannot be emphasized enough.
Now that you have your tools for a healthier life, it is up to you to make a healthy lifestyle happen. Be good to yourself, and you can live up to 100 years!
Dr. Ballard is a Board Certified Internist and Geriatrician with a special interest in Women’s Health. She practices in Enumclaw, 360-825-1389. Dr. Ballard’s comments are informational only and not to be construed as medical advice. Consult your personal physician for any medical issues.