The weather is turning cooler and outdoor activities are winding down. Unfortunately, we tend to become less physically active as we head into winter and our health tends to deteriorate a bit. Now is a good time to think about health maintenance issues and perhaps make an appointment with your doctor to get a check up. Insurance companies now pay for many health screening tests.
There are a number of organizations that publish guidelines for preventative health. These organizations can offer conflicting information. I prefer to rely on those provided by the U.S. Preventive Services Task Force (USPSTF) that are considered by some to be somewhat conservative.
The USPSTF is an independent panel of experts in primary care and prevention. The charge of the USPSTF is to systematically, and with as little bias as possible, review current scientific evidence and develop recommendations for effective clinical preventive services.
There are many ways to organize preventative guidelines, but the most common are by age and gender. In this column I want to focus on a few of the USPSTF health screening recommendations for adults.
Men and women should be screened for obesity by having a body mass index (BMI) calculated. This is done by taking your weight in pounds and multiplying by 703 then dividing that total by your height in inches squared. A person is classified as overweight if their BMI is between 25 and 30 and if they are over 30, they are considered obese.
Lipids are an important lab test to have done starting at age 35 for men and 45 for women and every five years thereafter. Men or women who have diabetes, high blood pressure, smoke or have heart disease in their family should be screened earlier.
Blood pressure should be checked every two years in those over 18 years of age if their blood pressure is less than 120/80 and yearly if over those values.
Starting at age 50, those without a family history of colon cancer should have a screening test for colorectal cancer. Tests can include testing stool specimens for blood, performing a flexible sigmoidoscopy (short scope) or a full colonoscopy or some combination of the above. Those with a family history of colon cancer may want to consider earlier screening. It's best to discuss the options with your doctor so you get the most sensitive, cost-effective test.
Screening for prostate cancer using the PSA blood test has also been a hotly debated topic in the last two years. The USPSTF recommends against screening anyone stating, in part, "...there is a very small potential benefit and significant potential harms." It's best that men discuss the pros and cons of PSA testing with their physicians.
If you have high blood pressure or high cholesterol or a family history of diabetes, have a blood glucose test performed. If you are feeling down or sad a screening for depression is recommended.
Men who are between 65 and 75 and have ever smoked cigarettes should be screened for an abdominal aortic aneurysm. This is done with an ultrasound machine and can identify a potentially fatal enlargement of the large artery in the abdomen.
There are specific recommendations for women. Breast cancer screening is controversial. The USPSTF 2009 guideline recommends mammograms every two years for women aged 50 to 74 years. Most insurance companies continue to follow the USPSTF 2002 guideline that recommends mammography every one to two years starting at age 40.
The USPSTF recommends screening for cancer of the cervix (Pap smear) in women aged 21 to 65 years every three years if done alone, or every five years if the Pap smear is done in combination with testing for HPV (Human Papilloma Virus).
A bone density test should be performed on women aged 65 years or older to screen for osteoporosis. A test for Chlamydia, a sexually transmitted infection that can lead to infertility, should be performed in women 24 years old or younger who are sexually active.
A great deal of information can be found at the USPSTF website at http://1.usa.gov/15zBN7t. You can also download the free ePSS app that is an excellent resource for preventative care recommendations from the USPSTF.