Monday, April 18, 2016

Preventative Medicine Screenings

By: Amita Chhabra M.D Hoover Primary Care

Cancer screening for many healthy individuals fall very low on the list of priorities. Preventative medicine and routine cancer screenings are important even for those without chronic conditions as it allows us to catch cancer earlier. And as the saying goes; “early detection is key”. There are so many preventative medicine screenings that your doctor preforms, unbeknownst to the patient and mentioned below are a few that may start a discussion in your home.

Depending on your provider and the guidelines they follow, cancer screening can vary. However primary care physicians are the foot soldiers in coordinating preventative medicine for their patients. Patients may not realize but a simple set of vitals can tell us so much about a patients overall health. Blood pressure screen, BMI, and weight. Your doctor will routinely run lab work with insight to your cholesterol, thyroid function, and anemia if necessary. All the above screenings and many more are preventative steps we take to recognize a disease process before it takes a toll on the body as a whole. It seems only fair that there are a few guidelines in which men and women are subject to the same intervals for certain cancer screening. One that perhaps is the most daunting; a colonoscopy.

It is recommended that men and women should be screened starting at 50 years of age unless there is family history or a previous indication. Colonoscopies should be performed every 10 years unless there is a finding that requires a shorter interval. However it’s important to ask your primary care provider for other options if the idea of a colonoscopy is too overwhelming. Flexible sigmoidoscopies, double contrast barium, CT colonography, and checking a fecal occult blood are all alternative options. However the gold standard of finding cancers, that can be biopsied, is a colonoscopy.

For women it’s worth mentioning that breast cancer screenings periodically change. However if you have a family history of breast cancer notify your health care provider. It could mean that you qualify for a baseline mammogram earlier than 40 years old. The American Cancer Society reveals women ages 40 to 44 should have the choice to start annual breast cancer screening with if they wish to do so. Women age 45 to 54 should get mammograms every year. Women 55 and older should switch to mammograms every 2 years or yearly. Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer. It’s not well known that pap smears are now recommended to start at 21 years to catch cervical cancer earlier. Cervical cancer screenings should start at age 21. Women between the ages of 21 and 29 should have a Pap test done every 3 years. HPV, the virus that causes cervical cancer, should not be used in this age group unless it’s needed after an abnormal Pap test result. Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called “co-testing”) done every 5 years. Breast cancer and cervical screenings are important in maintaining women’s health.

For Men, prostate cancer screening can also have varying guidelines. The American Cancer Society agrees it should be a discussion between provider and patient at 50 years old. If the patient is willing to go for further testing or biopsy then it would be an appropriate option to screen. African Americans, who have a father or brother who had prostate cancer before age 65, should have the discussion earlier starting at 45 years old. Depending on several factors, your doctor may choose to do a PSA level. If it is elevated it will likely be checked yearly, if not every 2 years depending on exam and other factors. Low sex drive, erectile dysfunction, fatigue and depression can all be signs of low testosterone. This could be due to a lot of factors but oftentimes insurance companies will pay for a screening testosterone for men over 40 years of age. Testosterone replacement should be discussed with your doctor, however many people are unaware that their symptoms could be alleviated with a simple screen.

Obviously there are so many more preventative medicine screenings that can’t be mentioned in one discussion. It’s important to allow your primary care physician to see you once at least once a year to address the above measures for an old fashioned checkup. It would allow the opportunity to address many cancer screenings, adult immunizations and preventative medicine screens.

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