WWR Article Summary (tl;dr) How about a “back to school” checkup? Ok, so you left school ages ago, that doesn’t mean you should put off that end of summer physical of years past. Infact, there are a number of checkups women should schedule before the end of year or prepare to make for 2017.
Conflicting or controversial health guidelines can keep you from getting the care you really need, or send you rushing around for tests that you could do without. So what medical screening tests do you actually need?
These days, more and more health organizations are nodding to the fact that (uh, hello!) we are all unique and many medical decisions need to be made individually.
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Having the kinds of intricate conversations with your doctor that can tease out your personal risk factors for various health concerns, however, can be tricky when you’re rushing through all your questions in a 15-minute appointment slot.
So, to help take at least some of the guesswork out of it, here are the big screenings you need, and how often to get ’em, as decided by the US Preventive Services Task Force, an independent panel of experts that evaluates the scientific evidence for various health screenings and services.
1. Cervical cancer screening
What it is: Your old “friend,” the Pap test, and a similar swab that tests for human pappilomavirus, or HPV.
Who should get it: Women ages 21 to 65.
How often: Every three years, or every five years if you’re between the ages of 30 and 65 and get the HPV swab and the Pap together. The good news? You probably don’t need the physical pelvic exam anymore.
Why it’s so important: Both tests look for changes in cells that could indicate a need for further testing, like a biopsy, says Tasneem Bhatia, a board-certified physician who specializes in integrative medicine. If it is cervical cancer, you want to catch it early, she says.
2. Colorectal cancer screening
What it is: The dreaded colonoscopy.
Who should get it: Adults ages 50 to 75. Those between ages 76 to 85 should discuss whether or not they should continue to be screened with their doctors.
How often: Every 10 years, assuming everything looks normal.
Why it’s so important: As unpleasant as a colonoscopy can be, it’s the best tool we have to pick up colon cancer or precancerous lesions or polyps early, says Nieca Goldberg, medical director of New York University’s Tisch Center for Women’s Health. Women may underestimate their risk for the disease, but it’s the third most common and most deadly cancer for women, behind breast and lung cancer, according to the CDC. If you have a family history of colorectal cancer, your doctor might recommend starting screening earlier and going back more frequently than once a decade, Bhatia says.
3. Breast cancer screening
What it is: A mammogram.
Who should get it: Women ages 50-74. Women between the ages of 40 and 49, as well as women 75 and older, should decide with their doctors about when to start and stop routine screening.
How often: Every other year, if you’re at average risk. With a family history of breast or ovarian cancer, your doctor may recommend more frequent mammograms.
Why it’s so important: As we’ve written about before, mammograms aren’t perfect, but right now, they’re the most effective tool we have for detecting breast cancer. “By catching breast cancer early, we can hopefully reduce cancer from spreading,” Bhatia says.
4. Blood pressure test
What it is: A measurement of the blood coursing through your veins with that arm cuff you’re used to.
Who should get it: Adults 18 and older.
How often: Once a year. Typically, this is done at an annual physical, which has itself become a bit controversial, Goldberg says. “I still think it’s important, because I still see to many people who aren’t taking good care of themselves,” she says.
Why it’s so important: Heart disease is the No. 1 killer of American women, and high blood pressure is a major risk factor. Getting screened means your doctor can make recommendations for your health based on the results, Goldberg says. If a blood pressure reading comes back on the border of normal and high, your doc might recommend diet and exercise changes. Medication might help for people who have crossed the threshold into high BP. After that, you’ll be tested more frequently to make sure whatever measures you’ve taken to stay healthy are actually working, she says. Because of its link to an increased risk of heart disease, stroke, and cognitive decline, it’s important to make sure blood pressure is well controlled, Bhatia says.
5. Lipid panel
What it is: This blood test measures your total cholesterol: your “good” HDL cholesterol, your “bad” LDL cholesterol, and your triglycerides, another kind of fat in the blood. Triglyceride levels are affected most by what you’ve recently eaten, Goldberg says, which is why many cholesterol tests are done after a short period of fasting. In general, staving off snacks for 4 to 6 hours before your test should be fine, she says.
Who should get it: Definitely women age 45 and older if they have increased risk of heart disease, and probably women ages 20 to 45 who have an increased risk of heart disease, too. (The USPSTF gives an A grade to the evidence supporting the use of cholesterol tests in older women and a B grade for younger women.)
How often: Once a year, if you’re healthy, to make sure there haven’t been any changes for the worse, Bhatia says. Younger women may not need a yearly screening if they’re healthy, Goldberg says.
Why it’s so important: High cholesterol is linked with heart disease, heart attacks and stroke. Keeping a general understanding of your levels may help you and your doc make heart-smart decisions to keep you healthy, particularly as you approach menopause. Estrogen is thought to raise that HDL (“good”) cholesterol; the natural drop in estrogen at menopause may be one reason why your heart disease risk increases as you age.
6. Hepatitis C test
What it is: A one-time blood test for the hep C virus.
Who should get it: Baby boomers. Adults born between 1945 and 1965 may have been exposed to contaminated blood that wasn’t rigorously tested. Widespread screenings didn’t go into effect until 1992, Bhatia explains.
How often: Once. High-risk adults _ typically past or current injection drug users _ may need to be screened more often.
Why it’s so important: While all adults born between 1945 and 1965 should get tested, women who had C-sections before 1992 are at particular risk, since they may have received blood transfusions that weren’t screened for the virus yet. In many people, the liver disease can be a silent one, Bhatia says. If you don’t have symptoms, hep C could be wearing down your immune system and might lead to cirrhosis or liver cancer if left untreated.
7. Blood glucose testing
What it is: As part of your routine checkup, your doctor might order a urine and/or blood test to test levels of sugar in your blood or pee to screen for type 2 diabetes or borderline pre-diabetes.
Who should get it: Women between the ages of 40 and 70 who are overweight or obese.
How often: Usually yearly, but more frequently if your levels put you in the pre-diabetes category, Goldberg says.
Why it’s so important: Type 2 diabetes is one of the biggest risk factors for heart disease, but having diabetes may also increase your risk for depression and eating disorders, both of which are already more common among women than men. The good news is you can take control of your blood sugar, and getting screened for abnormal levels can help you and your doctor make the changes that help postpone diabetes from progressing.
8. Osteoporosis screening
What it is: A bone density test.
Who should get it: Women 65 and older.
How often: If you’re not at risk, every 10 years might be enough, Bhatia says, but for women with family history of osteoporosis or a history of previous fractures, a doctor might recommend every other year, Goldberg says.
Why it’s so important: The scan can alert your doctor to any slips in bone mass, “which would increase the risk of injury and of declining mobility,” Bhatia says.
9. Depression screening
What it is: A conversation with your doctor about your mental health.
Who should get it: All adults.
How often: There’s more and more evidence it should occur somewhat regularly, although most doctors probably screen patients for depression only when they notice small signs or symptoms, Bhatia says.
Why it’s so important: Mental health can feel intimidating to talk about, so making it a part of regular health care can get more people the help they might secretly need. Depression is twice as common in women than in men and is a leading cause of disability around the world, according to the World Health Organization. Screening can help identify the best course of treatment before it becomes debilitating.