Whether you consider yourself an example of picture-perfect health, or you are dealing with a serious medical condition, it’s important to know what types of health screenings you need to stay as healthy as possible. Many of us struggle to stay on top of needed health screenings, particularly with COVID-19 scaring us away from medical appointments. In fact, the CDC reports that as of June 30, 2020, an estimated 41% of US adults delayed or avoided medical care including urgent or emergency care (12%) and routine care (32%) due to COVID-19 concerns. Another CDC report shows that even after COVID-19 stay-at-home orders were lifted, cervical cancer screening rates in California were still below 2019 screening levels: 29% lower for women in their 20s and 24% lower for women aged 30 – 65. However, COVID-19 is not the only reason people skip health screenings. For instance, in 2015, researchers found that only 8% of Americans aged 35+ received all of the recommended clinical services. Furthermore, almost 5% of adults did not receive any of the services! Find out below what health screenings you may need, then talk to your doctor to discuss your needs.
Health screenings save lives.
Health screenings can detect diseases in the early states, giving you the best possible chance for successful treatment. Since many diseases, including cancer, diabetes, and heart disease, can have few symptoms in the early stages, health screenings are crucial. Knowing what types of health screenings you need can help you get the right screenings at the right time. However, many people face barriers that make it difficult for them to receive needed tests. For more information on barriers and how you can overcome them, read Do You Know What Kinds of Preventive Care You Need?
Health screenings you need.
The information in the chart below is based on recommendations by the US Government (Healthcare.gov and the Agency for Healthcare Research) as well as from The Cleveland Clinic and the Skin Cancer Foundation. Importantly, experts update these recommendations as new data becomes available. Additionally, your doctors may recommend screenings not included in this chart and/or may recommend you skip some of these screenings. And your doctor may suggest you have screenings more or less often than stated in this chart.
What’s the scoop on each of these screenings?
The information below on the health screenings you need can help you determine which screenings are right for you. However, I highly recommend you talk to your doctor about your risk factors and which screenings he/she recommends for you. And, of course, follow through! Even with COVID-19 infecting people worldwide, it’s important to stay on top of preventive care to give yourself the best chance of a healthy future.
Abdominal Aortic Aneurysm (AAA)
These dangerous aneurysms occur when part of the aorta (your main blood vessel) expands in your abdomen. If the aneurysm grows large enough, it can rupture, causing dangerous, sometimes fatal, bleeding inside your body. Men over 65 who have smoked at any point in their life are at greatest risk of AAA and should be tested one time. Since women are less likely to have AAA, doctors do not routinely screen women. However, if you are a woman who is or was a heavy smoker, ask your doctor if you should be screened. The screening for AAA generally involves either an abdominal ultrasound, an MRI, or a CT scan.
A blood pressure test measures how hard your blood pushes against the walls of your arteries as your heart pumps blood throughout your body. Known as a “silent killer”, high blood pressure usually has no symptoms. Yet, 1 in 3 US adults have high blood pressure, which increases the risk for serious health problems, including stroke and heart attack. Unfortunately, your risk of high blood pressure increases as you age – see a list of risk factors here. Although all adults over 50 should get their blood pressure checked at least every 2 years, people with a history of heart attack, stroke, or other cardiovascular events should get tested more often. Fortunately, getting a blood pressure reading is quick and painless, and can even be done in your own home.
Osteoporosis is a bone disease that occurs when the body loses too much bone and/or makes too little bone. With osteoporosis, bones become weak and can easily break. Based on 2018 data, approximately 10.2 million US adults have osteoporosis, with an additional 43.4 million having low bone mass. Studies suggest that out of adults aged 50+, approximately 50% of women and up to 25% men will break a bone due to osteoporosis. A bone density scan, using x-ray detectors, is a simple, painless test to determine if you have osteoporosis. The scan results, which predict your chance of breaking a bone in the future, can help you and your doctor determine next steps for treatment.
Women should undergo their first screening when they turn 65, or sooner if history indicates an increased risk. The frequency for follow-up screenings varies depending on the patient’s condition and treatment. Interestingly, the US Preventive Services Task Force does not recommend routine screening for men because men have a higher bone mass and lose bone more slowly than women. However, groups such as the National Osteoporosis Foundation recommend testing for men 70 and older.
Breast cancer is the most common cancer in American women (except for skin cancers). The American Cancer Society estimates that in the US, in 2021, there will be 281,000+ new cases of invasive breast cancer in women, and 49,000+ new cases of ductal carcinoma. Additionally, they estimate that in the US, 43,600 women will die from breast cancer in 2021. Breast cancer is sometimes found after symptoms appear (see a list of possible warning signs of breast cancer here), but many women with breast cancer have no symptoms. Therefore, regular breast cancer screening with mammograms is critical.
Mammograms, low-dose x-rays, can help find cancer at an early stage when treatment is most successful. Some (but not all) imaging centers have a newer type of mammogram commonly known as three-dimensional (3D) mammography. The 3D mammograms appear to be better at detecting cancers – but research is underway to evaluate the difference between the traditional 2D and the newer 3D imaging. Note that 3D mammograms often cost more, and you may have to pay the added cost yourself. Yes – mammograms can be uncomfortable, but it’s definitely worth a minute of discomfort to catch a potentially deadly disease early! Most doctors recommend starting mammograms at age 50, repeating the test every 1 or 2 years. Because the guidelines for screening vary, speak with your doctor to develop a screening plan.
Cervical Cancer and HPV
A Pap smear test can find changes in the cervix before cancer develops. Moreover, it can find cervical cancer early when it’s small and easier to cure. In fact, the cervical cancer death rate dropped significantly as Pap test use increased. In addition to Pap tests, doctors now screen for HPV (human papillomavirus) since almost all cervical cancers are caused by HPV. Doctors generally recommend that women 21-30 get a Pap test without HPV test every 2 years. And women 31 – 65 should get a Pap test with HPV test every 3 years. According to the American Cancer Society, over 14,000 women will be diagnosed with invasive cervical cancer in the US in 2021. Additionally, an estimated 4,290 will die from cervical cancer in 2021 in the US.
Unfortunately, high cholesterol is common in the US. Almost 29 million US adults (aged 20+) have high cholesterol levels. Additionally, a total of 93 million US adults have levels considered borderline to moderately elevated. What exactly is cholesterol? It’s a waxy material found in your blood needed for important things such as making hormones and digesting fatty foods. However, too much cholesterol in your blood vessels makes it harder for your blood to flow through. Over time, this can lead to a heart attack or stroke. Although there are no symptoms related to elevated cholesterol levels, a simple blood test can check your cholesterol levels. Catching a high cholesterol level early can help you reduce your risk of dangerous outcomes. Doctors generally recommend a cholesterol screening every 4-6 years, but a family history of high cholesterol may require more frequent testing.
Colorectal cancer is the third most common cancer diagnosed in both men and women in the US (excluding skin cancer). The American Cancer Society estimates there will be 104,000+ new colon cancer cases and 45,000+ new rectal cancer cases in the US in 2021. And it’s the second most common cause of cancer deaths for men and women (combined) in the US.
Screening can help prevent colorectal cancer by finding (and removing) precancerous growths. Moreover, screening can identify cancer in its early stage when it can be easier to treat. The risk of colorectal cancer increases with age – see a list of other risk factors here. Men and women aged 50-75 should get regular testing. Screening usually involves either annual stool-based tests or a colonoscopy every 10 years. A colonoscopy allows doctor to look inside your colon and rectum, identifying and removing any suspicious growths. If you’ve had a colonoscopy, you know all about the very-not-fun bowel cleaning prep routine before the test. Fortunately, you receive anesthesia for the actual test, so the test itself is painless. Despite the unpleasantness, the benefits are well worth it – the death rate from colorectal cancer is dropping, likely due to the removal of precancerous polyps, the early detection of cancers, and improved treatments.
Depression is an illness that involves the brain. Approximately 17.3 million US adults aged 18+ had at least one major depressive episode in 2017. Depression can negatively impact your thoughts, mood and daily activities – see the signs of depression here. Fortunately, depression can usually be successfully treated, but only if your doctor is aware of your symptoms. If you have signs of depression, be honest with yourself and your doctor so you can get the help you need and deserve.
Diabetes – Type 2
When you have diabetes, your body struggles to turn glucose (sugars from food) into energy. Instead, the glucose builds up in your blood and your body is energy-starved. Over time, these high blood glucose levels can damage almost every part of your body. Type 2 diabetes is the most common form of diabetes, with a many risk factors – see a list of risk factors for type 2 diabetes. In fact, over 34 million Americans have diabetes, with around 90-95% of them having type 2 diabetes. If you are at risk for type 2 diabetes, talk to your doctor about screening. Fortunately, screening only entails a simple blood test. In general, people over 45 who are overweight should get test for diabetes. Additionally, you may need screening if you have other risk factors, such as high blood pressure or a family history of type 2 diabetes.
HIV, which stands for human immunodeficiency virus, is the virus that causes AIDS. AIDS causes significant damage to the immune system, leading to an increasing number of severe illnesses in AIDS patients. The only way to know if you have HIV is to get a blood or saliva test, since many people with HIV have no symptoms. In fact, in the US, an estimated 1 in 7 people who have HIV don’t know they have it. It’s important to get tested since early treatment for HIV can help you live a longer, healthier life. Everyone 15-65 should undergo HIV testing at least once. If you are in a high risk group, you likely will need more frequent testing – talk to your doctor.
Lung cancer is the 3rd most common cancer and the leading cause of cancer death in the US. Smoking accounts for approximately 85% of all US lung cancer cases. Unfortunately, almost 90% of lung cancer patients die of the disease. However, early-stage non-small cell lung cancer (NSCLC) has a better prognosis. Early detection of lung cancer using a low-dose computerized tomography (LDCT) scan can reduce the risk of death. On March 9, 2021 the US Preventive Services Task Force updated their recommendations for screening. This LDCT screening scan is now recommended for adults 50-80 who have a history of smoking at least 20 packs/year, and who currently smoke or have quit in the last 15 years.
Prostate cancer is the most common cancer among men (after skin cancer). The American Cancer Society estimates that in the US in 2021, there will be 248,000+ new cases of prostate cancer, and over 34,000 deaths. Screening involves a digital rectal exam and a blood test to look for prostate specific antigen (PSA). Abnormal results may lead to a biopsy. Some organizations recommend annual screening for most men should begin at age 50, with Black men starting screening at age 40. However, other organizations, including the American Cancer Society and the US Preventive Services Task Force recommend that men discuss the pros and cons of screening with their doctors before undergoing any tests.
Skin cancer, the most common form of cancer, is the abnormal growth of skin cells. It most often develops on sun-exposed skin, but it can appear on skin not normally exposed to sunlight. Fortunately, the two most common types of skin cancer – basal cell and squamous cell carcinomas – are highly curable, but can be disfiguring and costly to treat. Melanoma, the 3rd most common skin cancer, is more dangerous and can be deadly.
Since early detection of skin cancer gives you the greatest chance for successful skin cancer treatment, screening is important. Regularly screening yourself for suspicious moles or skin changes can help you find a cancerous growth at its earliest stages. If you notice something concerning, make an appointment to see your doctor. Additionally, the nonprofit organization Skin Cancer Foundation, suggests you see a dermatologist every year for a skin check, more often if you have you have a higher risk of skin cancer.
One important, final thought.
The information provided here does not constitute medical advice. You should talk to your doctor to determine what screening tests you need.
To get the most out of any doctor’s appointment, read these blog posts:
- 10 Tips to Communicate Better with Doctors.
- 10 Tips for a Better Medical Appointment.
- How Can You Get the Best Healthcare? Actively Participate!
- 6 Tips to Better Manage Your Care.
- Understanding Medical Information Is Harder Than Most Realize.
NOTE: I updated this post on 3-10-21.