Primary Care Screening
An ounce of prevention
Screening recommendations are made to assist us in assessing our risk of developing disease and identifying pathology that has arisen in our bodies. The goal is to "catch" any abnormalities in early stages or before the body develops physiologic changes into disease. For instance by monitoring a cholesterol panel we can see if levels are starting to elevate and address this with simple changes such as diet and exercise. Maintaining normal cholesterol levels and addressing changes early may prevent the development of coronary heart disease, heart attack or stroke later on. Identifying abnormalities early allows for better opportunities for most effective treatments with fewer side effects and generally better outcomes.
Screening recommendations can be confusing at times. They may vary based on gender and age as well by which association is making the recommendation. For best insight I make comparisons between some of the leading organizations including:
American Cancer Society
American Gastroenterological Association
American Heart Association
American Medical Association
Center for Disease Control and Prevention
National Institutes of Health/National Cancer Institute
National Osteoporosis Foundation
Primary care screening should include the following: (Variations in screening recommendations vary with a current or past history of disease. Discuss screening guidelines with your doctor.)
Breast
- Starting at age 40 yearly mammograms continuing until a woman is in good health.
- Clinical breast exam every 3 years for women 20-39 years old and annually thereafter.
- MRI in addition to mammogram may be recommended for women at higher risk due to genetic alterations, family history or other factor. Discuss this with your doctor.
Cervical
- Women ages 21-29 should have a pap every 3 years. HPV test should be added if there is an abnormal pap.
- Women ages 30-65 should have a pap test plus an HPV test every 5 years. A pap alone can also be done every 3 years.
- Women over age 65 who have had regular cervical cancer testing with normal results should not be tested for cervical cancer. Women with a history of serious cervical pre-cancer should continue to be tested for at least 20 years after that diagnosis, even if testing continues past 65.
- By age 35, if high risk, a woman should be offered an endometrial biopsy.
- Each year a woman should be informed about the risks and symptoms of endometrial cancer, and about the potential benefits, risks, and limitations of early endometrial cancer detection.
- At menopause women are strongly encouraged to report any unexpected bleeding or spotting to their doctor.
- Starting at age 50, men should talk with their doctor about the pro's and con's of testing.
- Testing includes a PSA blood test with or without a rectal exam. Frequency of testing will depend on their PSA level.
Beginning at age 50, both men and women should follow one of the following:
- Flexible sigmoidoscopy every 5 years, or
- Colonoscopy every 10 years, or
- Double-contrast barium enema every 5 years, or
- CT colonography (virtual colonoscopy) every 5 years
- Yearly fecal occult blood test or fecal immunochemical test
Lung
Discuss with your doctor the benefits, limitations, and potential harms of lung cancer screening with:
- Individuals ages 55-74, in fairly good health, with at least a 30 pack-year history of smoking (estimated by number of packs per day x number of years smoked), and are still smoking or have quit within the last 15 years.
- If screening is indicated, a low-dose CT scan of the chest yearly through age 74 as long as you remain in good health is recommended.
Type 2 Diabetes
Clinical judgement and patient preference will determine diabetes screening.
- Beginning at age 45, every 3 years particularly in those with a BMI >/=25kg/mg2
- Consider testing at a younger age or be carried out more frequently in individuals that are overweight and have one or more other risk factors.
Osteoporosis
Bone Mineral Density (BMD) should be performed:
- In women age 65 and older and men age 70 and older.
- In postmenopausal women and men age 50-69 based on risk factor profile.
- BMD and vertebral imaging to those who have had a fracture, to determine degree of disease severity.
- At DEXA facilities using accepted quality assurance measures.
Cholesterol
- Adults aged 20 years and older have their cholesterol checked every 5 years.
General Screening
Additional screening includes blood pressure, weight, dental, vision, hearing, immunizations, infectious disease, tobacco, alcohol, depression and physical exams. Based on age, gender and risk factors recommendations vary.
For more details go to: http://www.nlm.nih.gov/medlineplus/ency/article/002125.htm
www.freedigitalphotos.net/images
No comments:
Post a Comment