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Preventive Medicine and Routine Screenings Save Lives
Author: Nancy Stoll, MD
Specialty: Family Medicine
Living a healthy life involves eating well, exercising often, getting enough sleep and managing your mental health. However, one aspect that often goes ignored is the role of preventive medicine, including wellness screenings.
Consider this: According to the Centers for Disease Control, the five leading causes of death among females in the United States are cancer, heart disease, unintentional injuries, stroke, and chronic lower respiratory diseases. Of those, only unintentional injury cannot be screened for or prevented completely.
As a woman, I get it. You have a busy schedule and well-women’s exams are not exactly the most fun things in the world. But as a physician, I can tell you that routine health screenings, and preventive medicine in general, save lives.
What is Preventive Medicine
Preventive medicine falls into three distinct categories, primary prevention, secondary prevention, and tertiary prevention.
Primary prevention, which includes risk assessments and vaccinations, attempts to prevent certain conditions from occurring altogether. While flu vaccines and booster shots are the most obvious forms of primary prevention, it can also include things like banning hazardous chemicals or maintaining an active, healthy lifestyle. In these cases, the goal is to limit exposure, reduce risk, or outright prevent conditions.
Secondary prevention, like screening tests, seeks to detect problems at their earliest, most treatable stages. What screenings one may or may not need is largely based on what risk factors they have. Sex, age and family history are common factors that affect who needs what screenings and when. For instance, a woman over the age of 35 with a first-degree relative who has had breast cancer is at an increased risk of developing the disease, and therefore will need to schedule regular mammograms earlier and more often than someone who doesn’t have these risk factors.
Tertiary prevention is largely based on reducing the impact of conditions one already has. Rehabilitation and condition management fall under the tertiary prevention umbrella in that they attempt to improve function or lifespan. In these cases, the goal isn’t necessarily to get well, but to prevent complications that can adversely affect one’s health or quality of life.
Why are Screenings Important?
Health conditions need to be found before they can be treated. Some screenings, like colonoscopies and Pap smears, can detect polyps or abnormal cells before they turn cancerous. Blood test-based screenings, like cholesterol, blood pressure or blood sugar measurements, can diagnose, monitor, or determine whether you’re at increased risk for certain conditions. Routine screenings can help detect changes or abnormalities when treatment is easiest, most effective and least expensive.
Let’s take a look at some of the most common forms of screenings for women:
Well-Woman Visit (Annual Physical)
Typically, people think of Well-Woman Visits as pelvic and breast exams, but that’s not necessarily the case. Well-Woman Visits are all about preventive health and establishing a rapport with your primary care provider. Most annual well-woman visits are covered by insurance providers.
When: Annually
What:
Counsel on reproductive and sexual health, including contraception, HIV tests and STI tests.
Keep vaccinations up to date.
Mammogram
These screenings use specially-designed X-ray machines to scan breast tissue for lumps that may be malignant (breast cancer) or benign (non-cancerous fibrous tissue). Using this method, lumps can be detected even before they can be felt during a self-exam. It’s important to note that every breast is different, so mammograms are most effective when there are older results to compare them to. That’s why regular mammograms are so important.
When: Every two years for women aged 40-74 who are at average risk and in good health. Women who are at an increased risk should talk to their provider about when to begin screenings and may need to be screened yearly. Click here, to learn more about breast cancer risks.
What:
Pap Test
A Pap test, also known as a Pap smear, involves collecting a sample of cells from your cervix in order to detect cervical cancer or abnormal cells that may become cervical cancer. It is usually done at the same time as your pelvic exam, and may be combined with an human papillomavirus (HPV) test.
When: Every few years for women aged 21-65. Certain risk factors may require more frequent Pap tests, including diagnosis of cervical cancer or precancerous cells, HIV infection or weakened immune system.
What:
Heart Disease
Heart disease accounts for more than 22% of deaths in women, regardless of age or race. Heart health screenings include regular blood pressure checks, cholesterol (lipid panel) or blood glucose tests. Click here, to learn more about heart disease risk factors and the unique heart attack symptoms that present in women.
When: Blood pressure: During each provider visit, regardless of age. Cholesterol: Every 4-6 years for women who are at average risk; more frequently for women who are at increased risk for heart disease and stroke. Blood glucose: Every few years, beginning at age 45 if tests are normal; if prediabetic, more frequent screenings will be necessary.
What:
Colonoscopy
This procedure involves inserting a long, flexible instrument called a colonoscope through the rectum to the large intestine in order to find growths (polyps) on the colon lining. If abnormalities are detected, a small tissue sample will be taken for further study (biopsy).
When: Every 10 years; starting at age 50, if no abnormalities are detected. Every (3-5 years, if few non-cancerous polyps had to be removed.
What:
Bone Density Testing
As you get older, your body may begin to leech minerals (most importantly, calcium and phosphate) from your bones, making them weak and brittle. This is called osteoporosis. Bone Density Tests use X-rays to determine the mineral makeup of your bones and get an idea of your overall bone health.
When: Every few years; starting at age 65, if no risk factors are present. Starting at age 50, if risk factors are present such as rheumatoid arthritis, smoking, heavy drinking, low body weight, or breaking a bone in a minor accident.
What:
Obviously, this isn’t an exhaustive list of screenings available. There are skin cancer screenings, fecal occult blood tests, eye and dental exams, as well. Which screenings you need, how often you need to be screened and when those screenings should begin largely depend on what risk factors you have and, quite frankly, your need.
If you feel you need any of these screening tests or would like see what preventive services are appropriate for you, talk to your healthcare provider or find a Washington Hospital Healthcare System provider here.
Posted January, 2019