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Medical Screening Tools- which tests are right for you?

By: Kenneth Ripp, M.D.

There are a number of tests and screening tools available that help find medical problems at an early stage so they can be treated more easily and effectively. But along with the tests come questions. At what age should you be tested for the first time? Which tests are appropriate for you? How often should the tests be repeated? The best person to help you answer these questions is your primary care physician. He or she can look at your specific situation and assist you in developing a screening plan that is individualized to meet your needs. Before opting for any medical test, there are certain things to discuss with your doctor. First, learn about the test itself. What is the purpose of the test, and why do you need it? Ask about the pros and cons. What will happen if you don't have the test? If the test is positive, what treatment will be prescribed? You should also ask about the risks and side effects associated with the test, and whether there are alternative testing options available. Finally, you have the right to consider the cost of the test, and to establish whether the costs are covered by insurance. There are two terms that you may hear when discussing tests with your doctor. These are “false positive,” and “false negative.” Both terms refer to false results received from a testing situation. With a false positive, test results indicate that a patient has a medical condition, when in fact they don't. This can lead to unnecessary further testing as well as worry and anxiety for the patient who falsely believes that he or she has a medical problem. In a false negative situation, the test result comes back negative when, in fact, it should have been positive. In this case, the diagnosis of the medical condition is delayed and the patient may not start treatment as soon as he or she would have if the test results were accurate. While it's important to discuss your individual situation with your doctor, there are some general recommendations and guidelines available that can lead you in the right direction for which medical tests to consider, and when. For the most part, these guidelines are intended for the average person who is not at high risk for developing a certain medical condition. For instance, mammograms are recommended for women beginning at age 40; but a woman with a family history of breast cancer may want to consider having regular mammograms earlier than that.

Blood cholesterol This test measures total cholesterol levels as well as “good” HDL and “bad” LDL cholesterol circulating in the blood. It is recommended that you get your blood cholesterol checked beginning at age 20, and every five years after that. Blood pressure High blood pressure is an indicator of heart risk. Blood pressure screening is widely available, however results from automated systems – such as those at a grocery store or pharmacy – may not be accurate. Recommendations indicate that blood pressure be checked by a doctor or other medical professional beginning at age 18, and every other year after that. Clinical breast exam (CBE) and mammography Both of these tests are used to detect breast cancer. A CBE is recommended every three years until age 40, and yearly thereafter. A mammogram is recommended at age 40 and should also be repeated annually. Pap test Cervical cancer or precancerous cells are detected using this test. It is recommended that women age 20 to 30 receive an annual pap test to start. Depending on individual circumstances the interval may be lengthened to every two to three years. Women over 30 should have this test once every one to three years, depending on their individual medical history. Fasting plasma glucose Blood sugar levels – which can indicate diabetes risk – are measured with this test, which is recommended at age 45, and every three years following. Colon cancer screening There are three tests that identify problems in the colon, such as polyps or cancer. Your doctor can help you decide which of the three is best for your individual situation. The first, a fecal occult blood test, is recommended annually beginning at age 50. The second test, a colonoscopy, is recommended beginning at age 50, and should be repeated every 10 years. Finally, you may opt for a flexible sigmoidoscopy, which is performed every three to five years beginning at age 50. Skin exam Skin cancers and other irregularities can be detected during a total body skin examination. This test is recommended beginning at age 50, and should be repeated annually thereafter. Bone density This test is used as an indicator of bone strength and osteoporosis risk. It is recommended that women be screened at age 65. The frequency of retesting depends on individual factors and should be determined by your doctor. There are numerous screening tools and tests designed to detect medical problems early on so they can be treated most effectively with as little negative impact on the patient as possible. The guidelines here can help give you a general idea of which tests are recommended when. Family history, lifestyle habits, and other environmental factors may alter the general recommendations for your individual situation. The best way to know what is right for you is to discuss tests and screening tools with your doctor to develop a medical plan that meets your needs.

**************** Dr. Ripp is a board certified family practice physician at Raiter Clinic.