Dear Dr. Dave & Dr Dee, I'm 51 years old, and haven't seen a doctor in about three years and I am uncomfortable with pap smears in particular and wondered if maybe that is why I am reluctant to go to the doctor? I have always had a normal exam and feel healthy, so how much longer can I wait to have a check-up? Signed, Reluctant patient Dear Reluctant patient, Regular physical exams are important in order to stay healthy and to prevent problems from becoming worse. For example, age 50 and above is the recommended age for colon cancer screening, and you are overdue for your clinical breast exam and mammogram. Many diseases, if caught early, can be treated and cured. Some women feel more comfortable seeing a female physician for physical exams and pap smears. Your health insurance company can give you recommendations for female gynecologists or family physicians in your area. A Pap test is recommended every three years, but is only one of many important health screening exams for women. In brief are 13 health exams for women as outlined by the Mayo Clinic. 10 IMPORTANT HEALTH EXAMS FOR WOMEN (www.MayoClinic.com) The following recommendations are general guidelines on screening procedures for healthy women. Your doctor may recommend a different screening schedule based on a variety of factors, particularly your personal health history, age and family medical history. 1. Blood Pressure: for early detection of high blood pressure (hypertension) which if left untreated, increases the risk of heart attack, stroke, heart failure, and kidney disease. Recommendation: initial test at age 18, then at least every two years. 2. Breast Cancer: mammogram and clinical breast exam every one to two years. Your doctor looks for color changes, skin irregularities and changes in your nipples and also feels your breasts and armpits for lumps and enlarged lymph nodes in order to detect suspicious changes and to exclude breast cancer. Mammogram: X-rays of your breast tissue in order to detect breast lumps or suspicious changes or calcifications when they're too small to be detected by physical examination. These small lumps can be the first finding of early-stage breast cancer. Recommendation: a clinical breast examination in conjunction with screening mammography every one to two years, beginning at age 40. After age 50, your doctor may recommend annual mammograms. 3. Cervical Cancer: Pap test at least every three years. The cells from your cervix and the canal that enters your uterus are examined under microscope in order to detect cancer and precancerous changes of your cervix. You're at increased risk if you have a history of sexually transmitted disease, particularly human papillomavirus, have multiple sex partners, a history of abnormal cells in your cervix (cervical dysplasia), history of vaginal or vulvar cancer, or a smoker. Recommendation: within three years of your first sexual encounter or age 21, whichever comes first. You should have a Pap test at least every three years. You no longer need routine screening for cervical cancer if age 65 or older, you've had three normal test results in a row, you've had normal Pap tests over the past 10 years, and you aren't at high risk of cervical cancer, or you've had a total hysterectomy (surgery that removes your uterus and cervix). 4. Cholesterol: blood test, which measures total cholesterol. Undesirable levels of cholesterols can raise the risk of heart attack and stroke. Recommendation every 5 years over age 20 or more often if levels are abnormal. 5. Colon and Rectal Cancer: screening should begin at age 50. Tests examine your colon and rectum to detect colon polyps that may become cancerous or colon cancer before symptoms occur. Recommendation for higher level of risk for colorectal cancer: age 50 or older, or family or personal history of colorectal cancer or adenomatous polyps, or personal history of inflammatory bowel disease. Frequency of exam depend on type of procedure such as yearly fecal occult blood test (FOBT), flexible sigoidoscopy every 5 years, yearly FOBT plus flexible sigmoidoscopy every 5 years, double-contrast barium enema every 5 years, or colonoscopy every 10 years 6. Dental Checkup: dentist examines your teeth and gums in order to detect cavities within your teeth and problems with your gums, tongue and mouth. Recommendation: visit your dentist annually. 7. Diabetes: Fasting blood sugar test measures the level of sugar (glucose) in your blood after an eight-hour fast in order to detect risk of diabetes. Every 3 years age 45 or older or earlier and more frequently if at risk of diabetes. Also get tested if you have signs and symptoms of diabetes, such as excessive thirst, frequent urination, unexplained weight loss, fatigue, or slow-healing cuts or bruises. 8. Eye Health: ophthalmologist or optometrist checks your eye movement, peripheral vision, color vision and the sharpness (acuity) of your eyesight, and also views the inside of your eye using an instrument called an ophthalmoscope and, using a painless procedure called tonometry, measure the pressure inside your eyeball in order to determine whether you need glasses or contacts and to identify new vision problems such as glaucoma (increased pressure in your eye which can lead to vision loss), macular degeneration (deterioration of retinal cells which gradually decreases vision), or cataracts (clouding of the clear lens of your eye which blurs vision). Recommendation: once between the ages of 20 and 39, every 2 to 4 years between the ages of 40 and 64, and every one to two years after age 65. 9. Osteoporosis: bone density measurement is a painless scan of your lower back, hip region, wrist or heel in order to detect osteoporosis (a disease characterized by a loss of bone mass, which makes bones more fragile and likely to break). Recommendation: age 65 and older or, if you're at increased risk of osteoporotic fractures, begin routine screening five years earlier, at age 60. Certain factors put you at increased risk of osteoporosis, such as a low body weight, a history of fractures or a family history of osteoporosis. Factors associated with a risk for rapid bone loss include menopause or discontinuing estrogen therapy. 10. Weight: measure your height and weight to determine your BMI (Body Mass Index) in order to determine whether you're overweight or obese and to find out from your doctor whether your weight is a threat to your health. People who are overweight are more likely to have type 2 diabetes, high blood pressure and risk factors for other diseases. Two other exams are: 1. Sexually Transmitted Disease Screening: tests to detect infections spread by sexual contact (sexually transmitted diseases, or STDs) such as human immunodeficiency virus (HIV), gonorrhea, genital herpes and chlamydia. These diseases can damage your reproductive system and, in the case of HIV, can lead to life-threatening disease. Recommendation: In particular, STDs can be harmful to a pregnant woman and fetus. If you're pregnant, your doctor may screen you for the following STDs, depending on your level of risk: chlamydia, gonorrhea, hepatitis B, HIV infection, and syphilis. 2. Skin Exam: physician examines your skin from head to toe, looking for moles that are irregularly shaped, have varied colors, are asymmetric, are greater than the size of a pencil eraser, or have grown or changed since your last visit in order to detect skin cancer. Recommendation: beginning at age 20, a skin exam should be part of a routine cancer-related health checkup. For more information, see "Health Screening Guidelines" and "Women's screening tests: Prevent small problems from growing larger" at www.MayoClinic.com |
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