Your Guide to Preventive Care Screenings at Every Age
“We don't have to wait to get sick and then try to find a way to heal ourselves. Let's do the right thing…be on our own side. I think that that's the wisest thing — to prevent illness before we try to cure something.” -Maya Angelou, interview, May 2013
Even when we’re feeling great and have no complaints, preventative care is how we maintain that wellness. Regular screening and checkups are critical throughout life, which is why healthcare reform works to remove obstacles like cost and access to this essential service.
Birth to 18:
The American Academy of Pediatrics recommends regular checkups that vary by age and include screenings for hearing, vision, dental care, mental health, vaccinations, environmental exposures, and all systems of the body. These well-baby and well-child visits are critical for development and wellness for every stage. A detailed personal and family health history should be updated at least annually so that the pediatric care team can order any additional testing for high-risk conditions/syndromes.
Over 18:
Gynecological screenings:
The primary goal of regular GYN care is to identify cancers of the pelvic region (vulvar, vaginal, cervical, uterine, or ovarian) and breasts. This is done through examinations, surveys, and cellular samples like Pap smears. Typically done by an Obstetric-Gynecologist, these tests can also be performed by a qualified family practice or internal medicine provider. Those with personal history/family history that puts them at higher risk will need to follow different guidelines, as directed by their medical provider. For those with average risk, follow these guidelines.
Age 21 through at least 65: Annual GYN visits and regular Pap smears are highly recommended to prevent cervical cancer. There was a time when it was recommended that Pap smears began when sexual activity did, but data has shown that the rates for cervical cancer under 21 are extremely low and that the body at that point is capable of healing itself from the viral infection that most often causes it (HPV- Human Papillomavirus).
Annual GYN exams are critical. Even when they don’t include Pap smears every year, they involve vaccinations (HPV and more) a full assessment of the reproductive organs (including assessments of the ovaries and uterus), clinical breast examinations, general physical exams and surveys, and discussions on sexuality, safety, and mental, physical, and interpersonal health as well as STI’s (sexually transmitted infections). Pap smears are needed every 1-3 years depending on risk factors. Additional testing of cervical/uterine cells may be required.
Also, for those in child-bearing age, they include contraceptive and obstetric counseling, screening, and vaccines to ensure healthy pregnancies and those in menopause will involve assessments and interventions unique to that stage of life, including bone density and cardiovascular support and mitigation of menopausal symptoms.
As always, seek medical attention for any questions regarding symptoms of irregular menses, pain, itching, abnormal discharge, or other symptoms associated with hormones or reproductive organs.
Breast cancer screening:
To understand our personal risk for breast cancer, we must have regular personal/family health history surveys as well as imaging done for breast cancer screening. For those at higher risk, screening is done earlier and with more frequency. For those with average risk, follow these guidelines.
Age 20+
Although routine self-breast exams are associated with increased
testing of benign tissue, we all know people who discovered their own breast
tumors, so many, including breastcancer.org, still recommend self-examinations
in conjunction with clinical exams by providers and routine imaging. It is critical
that we all know our own breasts and can identify changes over time and here is
a step-by-step guide to self-examination.
Age 40 +
Annual clinical breast exams provided by OBGYN or PCP. Regular mammograms starting at age 40 (unless there is a risk reason to start earlier). The regularity after that will vary by history and unique breast type. Some patients will require additional types of imaging (ultrasound, MRI) and possibly cellular samples (biopsies) to rule-out breast cancers or catch them at the earliest possible time. Genetic testing may also be recommended, and further preventative care may be advised based on those results. Although routine self-breast exams are no longer required, it is important that we all know our own breasts and can identify changes over time.
As always, seek medical attention for any questions regarding symptoms of pain, itching, abnormal nipple discharge, or breast lumps.
Colon cancer screenings:
As with the other types of cancer, our risk factors depend on our personal and family history and age. There are a number of ways to assess colon health, and providers may recommend a combination of methods starting at, or before, age 45. Genetic testing may also be recommended and will impact the interventions recommended.
Age 45 through at least 76- regular colonoscopies is gold standard for identifying pre-cancerous and early cancerous lesions. The death rate of colon cancer has dropped as proactive testing has improved. The frequency with which these tests will be needed depends on the findings, but with normal risk factors, they are typically every ten years.
As always, seek medical attention for any questions regarding bleeding, pain, itching, or changes in bowel activity.
Skin cancer screenings - all ages
Skin cancer is the most common type of cancer and, although it is preventable by avoiding exposure to the sun, and highly treatable, it can be hard to detect before it gets to an advanced stage. Screening includes self-assessments of moles and other skin changes and routine examinations by a medical professional. For those with many moles or who are high-risk for other reasons, an annual skin-mapping appointment with a dermatologist is advised.
“To help you spot skin cancer early, when it’s most treatable, the American Academy of Dermatology recommends that everyone learn the ABCDEs of melanoma:
A is for Asymmetry: One half of the mole does not match the other half.
B is for Border irregularity: The edges are ragged, notched, or blurred.
C is for Color that varies from one area to another.
D is for Diameter: While melanomas are usually greater than 6mm (the size of a pencil eraser) when diagnosed, they can be smaller.
E is for Evolving: A mole or skin lesion that looks different from the rest or is changing in size, shape, or color.”
Other screening tests and interventions that should be regularly provided by a healthcare provider are blood pressure, diabetes, and cholesterol tests, assistance with quitting smoking, losing weight, eating healthfully, treating depression, and reducing alcohol use, routine vaccinations against diseases such as measles, polio, or meningitis and flu shots, as well as mental wellness assessments.
Start 2024 off right, by getting up to date on all healthcare screening and surveys!