The What, When and How of Health Screenings

By Tracy Wright

We have all heard about the importance of health screenings, but it may be confusing for many people to keep track of what screenings may be needed, at what age, and how often these screenings need to be done. Their main goal is early detection, and here is how you can find out why you should get one done.

For adults beginning at 18, annual well check visits with a primary care physician is recommended. Well-check visits include personal history, health counseling, blood pressure screening and any other preventive screenings. Adults should consult with their physician on when to start having their cholesterol checked by having a screening lipid panel.

“There isn’t necessarily a starting age for beginning the screening lipid panel,” said Katherine Huber, M.D., an internal medicine physician for UF Health Internal Medicine at Springhill and Tower Hill. “If someone has a family history of high cholesterol or is concerned about their own diet, they should speak to their physician about when is best to begin having the blood panel done. Depending on results, the frequency of the test will vary.”

Beginning at age 21, women should begin pelvic exams and pap smears. Family history and past history of irregular pap smears will alter at what interval exams should be recommended. Doctors may recommend a one-to-three-year interval between tests. Women should also check for breast lumps until age 40 when annual or biannual mammograms are typically recommended. The interval could depend on family history and past occurrences of breast lumps or conditions.

Men should also begin having regular testicular exams. For prostate screenings, it is typically recommended that men begin at age 50 unless a man has a high risk, then it can begin at age 40. There is also a PSA (prostate specific antigen) blood test and digital exam that can be done to assess risk factors.

Once an adult turns 50, colonoscopies are recommended for both men and women. If there is a family history of colon cancer or colon polyps then adults may be advised to begin at 40. The interval of testing is 10 years but that varies greatly depending on family history and what is found on the test.

There are also fecal tests that can be used in conjunction with colonoscopies for testing. The fecal immunochemical test (FIT) is a screening test, which looks for hidden blood in the stool. This can be an early sign of cancer. Cologuard is another test that combines the FIT testing with searching for DNA markers for colon cancer. Cologuard says that it finds 92 percent of colon cancers and 69 percent of the highest-risk precancers.

Many people know about these screenings because of large-scale awareness campaigns that have spotlighted heart disease, breast, cervical or ovarian, prostate, and colon cancers. However, there are other screenings that are just as important for adults to have.

More people are diagnosed with skin cancer each year in the U.S. than all other cancers combined. Huber said that she always recommends that patients go to the dermatologist every one to two years to have a full skin screening for suspicious moles or skin lesions.

“Especially living in Florida, where so much of our lives are outdoors, it is vitally important for people to screen their own skin and be vigilant about visiting a dermatologist with any suspicious skin lesions,” Huber said.

Huber also emphasized the importance of adults visiting an optometrist or ophthalmologist for a good eye evaluation to rule out signs of glaucoma. In addition, people should have dental health screenings and cleanings annually for general good health, as poor oral health can lead to systemic health conditions. Dentists can also evaluate patients for oral cancer.

Finally, at a certain age, blood exams should test fasting blood sugars for diabetes especially where risk factors are concerned, and at age 65, bone density scans should be done every 3-5 years for both men and women.

The importance of regular health screenings cannot be overstated, Huber said.

“These screenings are so vital because it allows us as health care providers to pick up abnormalities or problems at an early stage when conditions are much more treatable,” Huber said. “As a primary care physician, I can assuredly say that regular preventive screenings are a key to ensuring good health.”