Health Screenings Can Be a Lifesaver
(February 2012)
Despite some recent controversies and changes, periodic tests for serious illnesses can offer you a longer and healthier life.
Getting the health screenings you need when you need them can save you a lot of grief. But keeping track of the details may challenge you--especially when the details keep changing.
In 2009, the U.S. Preventive Services Task Force (USPSTF) concluded that most women in their 40s don't need mammograms, and that women ages 50 to 74 need them only every other year. And last fall, the USPSTF decided against continued use of the PSA test for routine prostate cancer screening because it often led to needless treatments that don't save or prolong lives.
Adding to your potential confusion, not all experts agree with every change to the screening recommendations. The American Cancer Society (ACS), for one, staunchly defends yearly mammograms starting at 40.
With that sort of debate grabbing headlines, perhaps it's no surprise that most of us just skip preventive services that could save our lives. Only one in four adults ages 50 to 64 is up-to-date with the federal recommendations that cover everything from cholesterol tests to cancer screenings to immunizations, according to the Centers for Disease Control and Prevention (CDC).
Yet there's plenty of proof that the right screenings can save lives. Here are just three examples:
Colorectal Cancer Screenings
These screenings can find precancerous growths called polyps in the colon or rectum so that a doctor can remove them before they turn into cancer. Screenings also find this type of cancer early, when it's easiest to treat.
The CDC credits screening with preventing roughly 33,000 colorectal cancer cases and saving about 16,000 lives in one recent five-year period. Yet a third of adults ages 50 to 75 aren't keeping up with their recommended colorectal screenings. It's not as if you don't have options for screening. Choices include an annual at-home fecal occult blood test, a flexible sigmoidoscopy every fifth year, or a colonoscopy every 10th year.
Blood Pressure Screenings
Earlier and better treatment of high blood pressure--which can only be found by an exam--plays a role in the falling death rates from heart attacks, blood vessel diseases, strokes, and kidney disease, according to the American Heart Association (AHA). In the past four decades, the mortality rate from heart and circulatory diseases has fallen about 65 percent.
Yet about one in five Americans who has high blood pressure doesn't even know it. That's especially troublesome because high blood pressure, sometimes called "the silent killer," has no symptoms.
A normal blood pressure reading is 120/80. The AHA says 77 percent of Americans treated for stroke, 69 percent who have had a first heart attack, and 74 percent who have congestive heart failure have readings higher than 140/90.
Getting your blood pressure checked is the only way to know if you should be making lifestyle changes or taking medication to get it under control.
Pap Test
Since being introduced in 1941, the Pap test has reduced cervical cancer-related deaths by about 74 percent. The latest recommendation from the USPSTF, ACS, and other groups fine-tunes earlier advice, generally advising women to get this test about every three years starting at age 21.
Screening Pros ...
In terms of preventive health, of course, regular screening tests are just part of the puzzle. You should also develop a relationship with a health care provider. Your doctor can keep an eye on your well-being, talk with you about a healthier lifestyle, discuss risky habits like smoking and excessive alcohol use, keep your immunizations up-to-date--and help you control illnesses when they do develop.
But screening tests can serve as the wake-up call that convinces you to make lifestyle changes a reality, the AHA notes. Learning that your cholesterol is out of whack may drive home the point that it's time to start eating better and become more active physically. Those problematic test results make it personal--a matter of your health and perhaps even your life, not just an abstract ideal.
... And Cons
What's the downside of screenings? False positive results can be a psychological blow, require further tests, and sometimes lead to risky, unnecessary treatments, the USPSTF says. In panning the PSA test, the USPSTF concluded that some needless treatments could be debilitating and even fatal.
Screening isn't perfect, says John R. Seffrin, Ph.D., the ACS chief executive officer. Screenings can miss cancer, or give you a clean bill of health just before aggressive cancer strikes. Cases can be diagnosed incorrectly. And some cases may never need treatment.
You should understand these limitations and talk with your doctor about the screenings that are right for you. The list can vary depending on your age, family history, race, and current health status.
Despite its drawbacks, Dr. Seffrin and other experts say, screening saves lives--so have that chat with your doctor sooner rather than later.
Key Recommended Health Screenings
Here are some of the health screenings most highly recommended by the U.S. Preventive Services Task Force:
- Blood pressure screening: Screening for high blood pressure for adults 18 and older
- Breast cancer screening: Screening every other year using mammography for women ages 50 to 74
- Cervical cancer screening: Pap tests every three years for women ages 21 to 65 who have had vaginal intercourse and have a cervix
- Cholesterol blood test: Screening to determine cholesterol abnormalities is strongly recommended for men 35 and older and women 45 and older if they're at increased risk for coronary heart disease. Screening is also recommended for men 20 to 35 and women 20 to 45 if they're at increased risk for coronary artery disease.
- Colorectal cancer screening: Screening using fecal occult blood testing, sigmoidoscopy, or colonoscopy beginning at age 50 until age 75. As the USPSTF notes, the risks and benefits of these three methods vary.
- Type 2 diabetes screening: Recommended for adults without any diabetes symptoms who have sustained blood pressure (either treated or untreated) higher than 135/80
By Bruce E. Beans, a feature writer
for Vitality. To learn more, visit the U.S. Preventive
Services Task Force at www.uspreventiveservicestaskforce.org.
© Krames StayWell. Information is the opinion of the sourced authors and organizations. Personal decisions regarding health, diet, and exercise should be made only after consultation with the reader's own medical advisers. This material may not be reproduced for redistribution without written permission from Krames StayWell.