HEALTHy LIVINg

seven TesTs

to keep your health on track

By Sheshe Giddens

Too often many of us take a reactionary approach to our health, especially when struggling to balance all of the demands in our lives. Women, in particular, are often pulled in many directions. Between the kids, work, marriage, parents and community activities, caring for themselves and their health becomes an afterthought. The reality is that each stage of our lives brings its own health concerns, and getting the recommended health screening is a great way to be proactive about your health, especially if there is a family history. Even if the tests confirm suspicions, early detection is critical. you may think that just because everything feels OK, nothing can be wrong, but not being screened is like telling the kids they don’t have to wash their hands if they don’t see any germs. Health screenings can give patients a glimpse into the future. They can help determine the risk for developing certain diseases or help catch diseases early. Many screenings simply involve drawing blood and/or conducting a physical exam. The following are some basic guidelines for various health screenings. Talk to your physician about which screenings you need, and when you need them. Many illnesses, when detected early, can be more effectively treated or cured.

1TYPE 2 DIABETES 3CHOLESTEROL

When should you be screened?

Healthy patients should be screened every three years beginning at age 45. Patients with a body mass index (BMI) greater than 25 and have one other risk factor should be screened annually. What are the risk factors?

If you are overweight or obese, have a family history of type 2 diabetes, live a sedentary lifestyle, have low HDL (the good cholesterol), high blood pressure or triglycerides, or are of a certain racial and ethnic group which includes AfricanAmericans, Hispanics, Asians and Native Americans/Alaska natives, then you are high risk. How is screening performed?

Screening for diabetes involves a simple blood test to determine the fasting blood glucose. Why is screening important?

Due to the nation’s expanding waistline, type 2 diabetes is now a national epidemic. A disease traditionally associated with older adults, now afflicts children as well. Diagnosing type 2 diabetes early is essential. Besides the long list of complications when the disease is not well-managed, it doubles a person’s chances of developing heart disease and stroke.

2COLORECTAL CANCER

When should you be screened?

Both men and women should be screened starting at age 50. What are the risk factors?

The risk increases with age, so anyone over 50 or who has the presence of polyps, a family or personal history of colorectal cancer, ulcerative colitis or Crohn’s disease is at risk. A diet high in red meat and low in fiber also puts you at risk. How is screening performed?

The preferred screening tool is colonoscopy, which is a procedure in which the doctor utilizes a long, flexible tube with a small camera mounted on it. The tube is inserted into the anus and guided through the rectum and colon. Usually a mild sedative and narcotic are administered before the procedure.

When should you be screened?

Women should begin screening at 55. What are the risk factors?

Patients who eat a poor diet, are overweight or have a family history of high cholesterol should be screened. How is screening performed?

A cholesterol screening is performed by a blood test. Why is screening important?

High cholesterol is a major risk factor for developing heart disease. “Since cholesterol can lead to heart disease, it is important for patients to know his or her numbers,” says Dr. Rebecca Gladu, associate director of the San Jacinto Methodist Hospital Family Medicine Residency Program. “In adults, I often order a lipid profile along with a complete blood count as part of my patients’ regular checkup. The number that I am really interested in is the patient’s LDL, also known as the bad cholesterol. This is where diet, exercise and medication can have the most impact.”

Why is screening important?

Colorectal cancer is the second leading cause of cancer-related death in the United States. With proper screening, 60 percent of those deaths could have been avoided. “On a national level, people are not getting the screening they need,” says Dr. Gulchin Ergun, medical director of The Methodist Hospital Digestive Diseases Department, Reflux Center and G.I. Physiology Lab. Ergun notes that precancerous polyps can be found in the colon and rectum up to 10 years before cancer develops. “That is why patients with who have a family history of colon cancer should start screening 10 years before their close relatives developed cancer,” she says.

5CERVICAL CANCER

When should you be screened?

Women should begin screening at age 21 or within three years of first having sexual intercourse, whichever comes first. Women over 30 years old should have the human papillomavirus (HPV) test every three years. What are the risk factors?

Women who have contracted HPV, taken birth control pills for more than five years, smoke cigarettes or have given birth to three or more children. How is screening performed?

The Pap and HPV tests are used to check for precancerous or cellular changes on the cervix. Why is screening important?

Cervical cancer is one of the most preventable gynecological cancers. Women are often screened during their annual well-woman exam. “Some patients are under the impression that the Pap screens for all gynecological cancers and it doesn’t,” says Dr. Jane Starr, an obstetrician/gynecologist at Methodist Sugar Land Hospital. “It only checks the cervix. Women over 30 should discuss HPV testing with their doctor. Recommending this testing to patients is becoming more of the norm.”

4BONE DENSITy

When should you be screened?

Women over 65 years old should have a bone mineral density (BMD) test performed to assess their risk for osteoporosis. What are the risk factors?

Risk factors for osteoporosis include having a bone fracture when over age 50; a history of rheumatoid arthritis, chronic kidney disease or an eating disorder; early menopause; history of hormone treatment for breast cancer; a family history of osteoporosis and loss of height. Also, women who are either white or from Southeast Asia are at a higher risk. “Long-term use of steroids such as prednisone increases the risk of osteoporosis. Also, taking certain hormones like progesterone long-term can increase one’s risk,” Gladu says. How is screening performed?

A DEXA scan, which uses low-dose X-rays, measures the amount of calcium and other minerals in your bones. Why is screening important?

As we get older, we loss bone density. The scan checks for calcium and other key minerals in the bones. The less dense the bones, the higher the risk for bone fractures, which can be a sign of osteoporosis.

6BREAST CANCER

When should you be screened?

Women should have their first mammogram at age 40. What are the risk factors?

Women with a family history of breast cancer or who are overweight, used long-term hormone replacement therapy, have never given birth, have breast cancer-related genes BRCA1 or BRCA2, or have taken birth control pills have an increased risk of developing breast cancer. “Most of my breast cancer patients are post-menopausal because a woman’s risk increases with aging,” says Dr. Anna Belcheva, an oncologist at Methodist Willowbrook Hospital. “Regardless, following the recommended guidelines is important because breast cancer does affect younger women.”

How is screening performed?

A mammogram is a form of imaging that is used to detect abnormalities in the breasts. Women should also perform a monthly breast self-exam to note any changes in the breast. Why is screening important?

“Most women who develop breast cancer do not have any risk factors,” says Dr. Luz Venta, medical director of the Methodist Breast Center. “Since the onset of annual screening mammography in the 1990s, the mortality rate from breast cancer has decreased by 30 percent. This increased survival is no doubt the result of early detection, as well as advances in treatment.”

7gLAUCOMA

When should you be screened?

According to the American Academy of Ophthalmology, healthy patients should be screened once between ages 20 to 39 and every three to five years if they are high risk. Patients ages 40 to 64 should be screened every two to four years. Patients 65 and older should be screened every one to two years. What are the risk factors?

Patients who are over 60, have a family history of glaucoma, African-American or Hispanic are at higher risk. Glaucoma is the leading cause of blindness in African-Americans, who are six to eight times more likely to be affected by glaucoma than whites.

How is screening performed?

During a routine eye exam, drops are used to numb the eyes and then a tonometer measures the intraocular pressure. Glaucoma is associated with an excessive buildup of eye pressure. Because the pressure normally fluctuates daily, the optic nerve also needs to be evaluated.

Why is screening important?

“Glaucoma initially affects peripheral vision, and individuals are often unaware of the change. By the time patients are aware of it, the disease has progressed significantly and has affected the central part of the patient’s vision,” says Dr. Hilary Beaver, an ophthalmologist with Methodist Eye Associates. “At that point, the damage is often irreversible. That is why glaucoma is known as the silent ‘thief of sight.’”

To learn more about any upcoming health screenings offered by The Methodist Hospital System throughout the greater Houston area, visit methodisthealth.com or call 713-790-3333.

HEALTH SCREENINgS By AgE

Screening

Diabetes (type 2) Diabetes with risk factors Colorectal cancer

Colorectal cancer with risk factors

Bone density

Cervical cancer

Breast cancer

Cholesterol

Glaucoma

Glaucoma with risk factors

18–39 40–49 50–64

65+

Start at 45, then every three years Annually with BMI ≥ 25 and patient has one other risk factor Start at 50, then every five to 10 years

Start at 45 if African-American or earlier if family history

Screening Method

Fasting blood glucose

Colonoscopy

Start at 21 or with onset of sexual activity, then annually (Pap) Start at 30, then every three years (HPV testing) Annually for women Bone densitometry test over 65 (DEXA scan)

Pap and HPV test

Start clinical breast exam at 21, then every three years Start mammogram at 40, then every one to two years Breast self-exam and mammogram

Start at 55, then every five years Lipid profile –triglycerides, total cholesterol, HDL and LDL

20–39, one screening 65 and older, every one to two years

20–39, every three to five years 40–64, every two to four years 65 and older, every one to two years