Many people are confused about what tests and screening examinations are important for their health. Some basic tests are important for basic health. Other tests are necessary if you are having health problems. This article addresses basic screening tests and examinations that everyone should have, based on age. If you have health issues, there are other tests that should be done. That will need to be another article.
Prenatal Exams – You should call and make an appointment as soon as you are sure you are pregnant. Most doctors will want to see you some time in the first trimester (first 12 weeks) to determine when you conceived. This will help determine your due date, known as EDC or Estimated Date of Confinement. You should know the date of your last period and how far apart your cycles are. You will have a physical exam including a pelvic examination, a pap smear, some cultures and blood work. Dates of further exams are determined based on information from the first examination and your risk factors. Your health and the health of your baby are very important, so keep these visits.
Well baby / child exams – Your baby will have been seen in the hospital for a newborn examination. When you are discharged, you will be told when you should see your pediatrician or family physician. It is important to keep a regular schedule of “well baby” examinations. The doctor will be checking the baby’s weight and growth. Certain developmental landmarks are important to reach. They are variable, but patterns of delay are important to watch for. Things like walking, picking up objects, turning over, and many other small achievements mean that a child is or is not developing normally. Your doctor is trained to watch for all these things. You also have someone to call if you have a problem.
Vaccinations – These should be discussed with your doctors at every stage of your life. We start giving some of them early in life. There are even some that are specific for people who are over 65 (like Shingles and Pneumonia). So ask your doctor if it is time for vaccinations.
School, Sports, Camp and Work Physicals – We are asked to do these frequently. There actually is a reason for these examinations. The organization does not want to be surprised by someone who has heart disease, diabetes or some other disease. This is especially true if you are out in the woods, hundreds of miles away from anyone. I have found heart murmurs, high blood pressure in teenagers, some people who could hardly see or hear, and many other problems on “routine” physicals.
Well woman exams – This is the exam that most women get when they go for their annual gynecology exam. It should include at the minimum a breast exam and a complete pelvic examination. If you have other problems, they should be addressed or you should be referred. Depending on your age, you may have a mammogram set up. Pap smears and cervical cultures are done on a regular basis, though not necessarily every year.
Colonoscopy – This test involves passing a flexible lighted tube through the anus and examining the large bowel and part of the small bowel. These days a camera is attached to the “scope” so that photos can be taken. Instruments can also be passed so that biopsies can be taken if necessary. This test is recommended in anyone who is 50 years of age or older. If the test is negative, it doesn’t need to be repeated for 5 to 10 years. If there is a family history of colon cancer, a change in bowel habits or blood in the stool, the test may need to be done earlier.
Mammogram – The recommendations concerning mammograms are controversial at this time. You will need to discuss this with your doctor. Standard recommendation used to be to start at age 40 unless you are high risk. Then you should have a mammogram every 2 years until age 50, when you start having them annually.
PSA (Prostate Specific Antigen) – This is a blood test to help determine if a man has prostate cancer. The test is generally recommended at age 50 and older. For those who are at high risk, it may be started as early as age 40.
Prostate Examinations – These are recommended starting at age 40 by the American Urological Association. Some physicians recommend starting at age 50. This varies depending on your family and personal history of prostate problems. They should then be offered every year. The alternative is to do a digital rectal exam every 4 years with a prostate ultrasound at the same time. You should discuss this with your physician and your insurance company.
Testicular exams – These should be done at varying times during a man’s life. As an infant, the testicles are checked to make sure they have both descended into the scrotum. If not, there are various things that may need to be done. They should then be checked periodically by a physician as part of the male genital examination. Most physicians recommend that a man become comfortable with examining his own testicles. Again, it is important that the testicles are descended into the scrotum. Absent or undescended testicles need further evaluation (Undescended testicles can cause cancer). The testicles should be relatively smooth. Any lumps, especially if they are hard, should be checked by a physician. Areas that feel like “spaghetti” or “a bag of worms” can be a varicocele. This is a group of dilated veins that can cause infertility in some men. Soft, full areas can be a hydrocele (fluid filled sac) or a hernia, and should also be seen by a physician.
These are just the basic “screening” exams. I hope you are healthy and pass with an A+. If not, hopefully your problems are detected early because you have been getting checked regularly.