By Dr. Rwanda Campbell, August 6, 2009
1. A Pap Smear Test examines cells for any changes that may indicate the possibility of cervical cancer. Campbell recommended that the first test be conducted at the age of 20 or at the onset of sexual activity and continued annually until age 65 or 70. She said some insurance companies allow the test annually and others cover the test every three years if test results are normal. Even if the pap smear isn’t performed every year, Campbell said it is important for every woman to have an annual pelvic exam.
2. A cholesterol blood test is important because high cholesterol levels have no symptoms but can be deadly. Excess LDL, or bad cholesterol, can cause build-up in the arteries and interfere with blood flow. HDL, the good cholesterol, has protective qualities and can remove LDL from the blood. Some pediatricians now test cholesterol levels and Campbell said everyone should get a baseline test by the age of 20. The test should be repeated at least every five years until the age of 45. Anyone older than 45 with a family history of heart disease or high cholesterol levels should be screened annually. While medications are available to lower cholesterol levels, the physician said it is better to lower cholesterol through diet modification.
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3. Breast exams are recommended at age 30 and every three years after that while mammograms are recommended annually beginning at age 40. A clinical breast exam checks breast tissue for lumps, thickening or other changes that warrant follow-up. Mammograms are X-rays of the breast tissue that may find cancers when they are still too small to be felt. Breast cancer is most curable if it is found in its earliest stages. Campbell said genetic testing is available to women whose mothers or sisters have had breast cancer.
4. Skin cancer screenings should begin by the age of 30 and be conducted annually thereafter. A primary care provider or dermatologist may do head-to-toe screenings. Skin cancer is the second most common cancer in women and is curable if it is caught early. Women with fair skin, repeated sunburns, many moles and a family history of skin cancer are have the highest risk of developing skin cancer.
5. Thyroid lab tests are needed to make sure the gland is functioning properly. The thyroid gland regulates the way the body uses energy. If the thyroid gland is overactive, it may lead to rapid weight loss and nervousness. If it isn’t up to speed, a person may feel weak, fatigued, generally unwell, depressed and suffer from excessive vaginal bleeding. Early diagnosis can avoid more debilitating conditions like heart disease, high cholesterol and stroke, she said. Screenings should begin at the age of 35 and continue every five years, or more often if the woman experiences thyroid symptoms or has risk factors, such as a family history of thyroid problems. Thyroid problems may be adjusted with medication.
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6. Blood pressure levels are checked every time a person visits a doctor. High blood pressure levels can lead to heart attack, stroke, heart failure and kidney damage. High levels produce no symptoms. Campbell said high blood pressure is often weight related for women. Blood pressure readings should be below 140/90. High blood pressure, or hypertension, may be treated with lifestyle changes and/or medication.
7. Diabetes is a condition in which the body doesn’t make enough insulin or has a reduced response to insulin. It will cause blood sugar levels to be too high and increase the person’s risk of heart disease and stroke. It can also result in birth defects during pregnancy and premature menopause. Screening guidelines call for testing by the age of 45 or sooner if risk factors are present. Campbell recommended screenings before that and for any woman who is overweight.
8. Colonoscopies examine the large intestine for signs of colon cancer, which is 90 percent curable if found early. Growths and polyps may be removed and biopsied during the test. Preparation for the test (a bowel cleansing) is a bigger challenge than the test itself because patients are usually asleep during the procedure, the physician said. The first screening is usually done when the patient turns 50 and is repeated every 10 years if no polyps or risk factors exist. Higher-risk patients, such as those with a family history of colon cancer, should get their first test 10 years before the family member was first diagnosed and every five years after that.
9. Bone-density scans measure the mass of a patient’s bones and assess her risk of developing osteoporosis. Campbell said a broken hip could be a life-changing event; it can mean moving to a nursing home. Weight-bearing exercise, Vitamin D and calcium help build bone mass in younger patients, but medicines may be needed in older patients. Women may lose up to 20 percent of their bone density in the five to seven years after menopause. Campbell recommended women have their first bone-density screenings by age 65 and that they be repeated every five years. Doctors may suggest testing at an earlier age for patients who are underweight, have ever smoked, have a recent history of broken bones or a family member with osteoporosis.
10. Hormone Blood Tests that Assess your menstrual cycle is the last test for women and one that directly affects quality of life for many women. Campbell said she encounters patients who live in fear of having menstrual accidents and who won’t leave home because their flow is too heavy. “That is not normal,” she said. “There are many options available for women today.” Medications and ablation may both reduce the severity and length of periods. Hysterectomies, which used to be the only option, are now considered options of last resort.
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