Screening Test / Wellness examinations

 

Dr Maria Zweig, MD

 

At what age, should I be doing what testing, as a part of routine examinations?

 

We all should be doing a certain amount of general testing that is recommended as part of a good health maintenance examination program.  As woman’s health specialist we not only look out for reproductive health issues but general health problems as well. These are going to vary depending on your overall health status, age, sex and family history.  I am going to review the basics based on certain age groups, from adolescence onward for women.

 

Late adolescence through your 20’s.

 

At this age we look for signs of problems for the future, and try to set the groundwork for the next couple of decades.

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          • Check blood pressure
          • Weight
          • Vitamin D levels
          • Glucose and lipid levels
          • Hemoglobin (CBC)
          • Sexually transmitted disease
          • Start Pap smear testing at 21
          • Dentist yearly

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The general sense of testing at this age is to verify any diseases not detected by your pediatrician as an underlying health problem and control them early. Nutritional problems – deficiencies or excesses’, anemia’s, diabetes, blood pressure problems, and once sexually active preserve fertility. Testing at this age if initially normal may be done yearly or on a 3 – 5 year interval depending on the individual situation.

 

Reproductive age. Late 20’s through your 30’s.

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          • Check blood pressure
          • Weight
          • Hemoglobin (CBC)
          • Metabolic Panel (CMP)
          • Urine analysis (UA)
          • Lipid panel (cholesterol testing)
          • Thyroid testing (pregnancy – TSH)
          • Sexually transmitted disease
          • Pap smear
          • Dentist yearly

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At this age women are or should be generally healthy, so we do the basics – nutritional, keep an eye for future problems and plan for well being for future pregnancies. Any time a woman changes sex partners we recommend checking for sexually transmitted disease. We do cervical cancer testing at this age because we can prevent disease down the road. We keep an eye on any developing disease, and here in Puerto Rico we especially look for diabetes, hypertension, and any risk factors for renal disease. Testing if healthy can be done yearly to every 3 years.

 

Your 40’ through 50’s.

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          • Check blood pressure
          • Weight
          • Hemoglobin (CBC)
          • Metabolic Panel (CMP)
          • Urine analysis (UA)
          • Lipid panel (cholesterol testing)
          • Further Cardiovascular Testing depending on risk factors present.
          • Pap smear testing
          • Colon cancer screening

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            • Stool for occult blood (40’s – yearly)
            • Colonoscopy (start at 50 then, every 10 years or depending on risk factors)

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        • Breast Cancer screening – Depending on Risk Factors every year or 2 years

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          • Mammography
          • Breast sonomammography
          • Breast Tomosynthesis (3-dimensional mammography)
          • MRI Breast

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        • Vitamin D testing
        • Dentist – yearly. Eye exam every one 2 years depending on risk factors.

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Here we start really looking for the big killers of women – heart disease and cancer. Heart disease is the #1 killer of women. We look for high blood pressure, diabetes, cholesterol problems and any risk factors for kidney disease. We continue screening for breast and cervical cancer; start colon cancer screening. We look ahead at possible bone disease – osteoporosis – risk factors. Usually we see patients yearly and testing between every one to two years.

 

Sixties and beyond.

 

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          • Check blood pressure
          • Weight
          • Hemoglobin (CBC)
          • Metabolic Panel (CMP)
          • Urine analysis (UA)
          • Lipid panel (cholesterol testing)
          • Pap smear testing – every one to three years depending on risk factors.
          • Colon cancer screening

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                    • Stool for occult blood (yearly in between colonoscopy)
                    • Colonoscopy (every 10 years or depending on risk factors)

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              • Breast Cancer screening – Depending on Risk Factors every one or 2 years

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                    • Mammography
                    • Breast sonomammography
                    • Breast Tomosynthesis
                    • MRI Breast

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              • Vitamin D testing
              • Densitometry (Osteoporosis screening depending on risk factor every 2 – 3 years).
              • Cardiovascular Testing

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                    • CRP Cardiac Specific
                    • Stress testing
                    • Carotid Doppler
                    • Echocardiogram
                    • Cardiac Holter – arrhythmia

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                • Thyroid testing (TSH, T4)
                • Dentist – eye – exam yearly

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At this age your doing maintenance, keeping everything under control, and still keeping an eye out for any new diseases’. Keep in mind biggest killer in women is still heart disease. Common diseases we look for:

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          • High blood pressure
          • Diabetes
          • Renal disease
          • Thyroid disease
          • Bone health – arthritis – osteoporosis – hip and vertebral fractures.
          • Respiratory disease – asthma – COPD.
          • Dementia – Alzheimer’s – Parkinson’s
          • Cancer

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Till what age should I continue testing?

My usual answer is that as long as my patient enjoys good health, I like to see them every year. I don’t always perform the long list of testing and I simplify or reduce testing depending on general status of health, results of previous testing, degree of patient functioning and previous medical history. Having said this, I see many of my patient’s into there 80’s, 90’s and above!