There’s no getting round it: as we move towards middle age and beyond, the wear and tear on our bodies begins to show. Given the plethora of advice and information we have at our fingertips these days, it’s no wonder many of us interpret every ache and pain as bad news. We are obsessed, often needlessly, with the state of our health. Ironically, the tests that could set our minds at ease are just a phone call away. As the saying goes, prevention is better than a cure, especially in these days of screening programs and early detection. So this year, why not take control of your health? Here is HL’s top 15 tests you should check out and why.
Mammogram
Why? An estimated one in nine women will develop breast cancer, and the risk increases with age. In Canada in 2006, some 21,600 new cases were diagnosed and over 5200 deaths reported. Early detection offers better treatment options and improves chances of recovery.
Who should have it? Mammograms are often done as part of an ongoing screening program, whether the woman has symptoms or not, or can be recommended by a doctor if a lump is detected by the patient herself or during the course of a routine examination.
When? In general, mammograms are recommended every two years for women aged 50 to 69. Studies indicate that deaths from breast cancer can be reduced by up to a third as a result. For women 70+ or those with a family history, doctors may recommend a different screening interval.
How can I reduce my risk? Self-examination and regular screening can reduce your risk. A low-fat diet, limited alcohol and no smoking are also recommended.
Pap Test
Why? Cervical cancer ranks number 10 in the list of most common cancers among Canadian women of all ages, but jumps up to third place among women aged 20 to 49. A Pap smear test can detect changes in the cervix before they become cancerous and when treatment can prove most effective. Since the Pap test was introduced, the death rate from cervical cancer has dropped almost 50%. As a result, the survival rate is now up to 74% over five years.
Who should have it? All women should have a Pap test at age 18, or as soon as they become sexually active.
When? After a year, a second test should be done. If the first two tests are clear, re-screening should be done every three years up to age 69. For women 70+ who have had at least two clear tests, with no cervical abnormalities reported in the past nine years and no history of cancer, regular screening is not needed. Also, women who have never had sexual intercourse, and those who have had a hysterectomy with previously normal tests, do not require re-screening.
How can I reduce my risk? Limiting your number of sexual partners, knowing your partner’s sexual history, using condoms and regular screening can all lower
your risk.
PSA Test
Why? Every year, in Canada, about 20,000 men are diagnosed with prostate cancer, and about 4300 die from it. Recent studies indicating that PSA screening before men experience any symptoms can reduce their risk by as much as 35%. Because death from prostate cancer usually results from
the spread of the disease, early screening is critical.
Who should have it? The PSA test is a simple blood test. According to The Prostate Cancer Research Foundation of Canada, men over 40 should consult their doctor about the benefits of a PSA test. Early screening is successful. It is advisable for younger men to make inquiries as well.
When? As soon as possible if over 40 or if any abnormal symptoms are being experienced.
How can I reduce my risk? Age, weight, smoking and alcohol are all factors. You might not be able to do anything about your age, but the other three are within your control.
Testicular Cancer Check
Why? Although testicular cancer accounts for only 1% of cancer in men – striking one in every 25,000 – it is most common between the ages of 15 and 35. The good news? It’s almost always treatable if detected early, even if it has already started to spread. A monthly testicular self-examination should be done to reveal any abnormalities or changes in shape.
Who should have it? Any male experiencing symptoms such as a painless lump in the testicle, enlargement of the testicle, dull ache or pain in the groin, abdomen or testicle.
When? As soon as possible if any abnormal symptoms are being experienced. Following a diagnosis of cancer and subsequent treatment, blood tests and chest X-rays every month for one year and every two months for the second year are recommended.
How can I reduce my risk? The outlook for testicular cancer is positive, but as there are as yet no recognized causes, early detection through self-examination is the key.
Colorectal Screening
Why? In 2007, some 20,800 Canadians were diagnosed with colorectal cancer (CRC), with about 8700 dying from it. Although CRC is the third most common cancer overall in Canada, the good news is that regular screening leads to early diagnosis and increasingly successful treatment. CRC usually develops as a result of benign tumours or polyps found in the bowel. Testing includes ultrasound, digital rectal investigation, or examining the stool for blood (FOBT). If further testing is required, a colonoscopy is usually prescribed.
Who should have it? Regular screening is recommended for those over 50, although anyone experiencing problems or symptoms should consult their doctor. The risk increases with age, with most CRCs detected in those 70 and over.
When? The Canadian Task Force on Preventative Health Care recommends an FOBT every year or two for people over 50, with follow-up colonoscopies for those testing positively.
How can I reduce my risk? Eat less red meat, more fruit and vegetables, consume less alcohol and quit smoking. Obesity and low levels of physical activity increase the risk factor, as does heredity.
Diabetes Screening
Why? With over 60,000 new cases being diagnosed annually in Canada, type 2 diabetes is one of the nation’s fastest growing conditions: nine out of 10 diabetics have type 2. Type 1 means the body makes little or no insulin; type 2 means the body makes insulin but cannot use it properly. Unfortunately, type 1 diabetes cannot yet be prevented. Symptoms develop rapidly and people with this condition are insulin-dependent. In type 2 diabetes, symptoms develop more slowly; in fact, many people experience no symptoms at all. Worryingly, some 2,000,000 Canadian adults have diabetes, with about a third unaware of this potentially life-threatening condition. Diabetes ranks seventh in the list of leading causes of death in Canada, and over time, can result in blindness, heart disease and stroke, and amputation.
Who should have it? The most common symptoms include fatigue, frequent urination, extreme thirst and sudden unexplained weight loss. Anyone experiencing these symptoms should consult their doctor. A simple urine test will determine the level of glucose in the urine, which is an indicator of diabetes.
When? Because diabetes can occur at any time, tests should be carried out regularly in those showing symptoms, and every three years in those over 40, especially those who are overweight. How can I reduce my risk? Fortunately, type 2 diabetes can be postponed, and even prevented, by healthy lifestyle choices. Quit smoking, maintain a healthy weight, keep active, eat less fat and sugar, eat a balanced diet, keep your cholesterol low and your blood pressure normal.
Bone Density Test
Why? Osteoporosis, which in Canada affects 25% of women and one in eight men over 50, causes bones to become thin, weak and brittle, increasing risk of fracture over time. Unfortunately, there are usually no warning signs, so a bone density test can be beneficial.
Who should have it? Women are especially at risk of developing osteoporosis, especially during the menopause when decreasing estrogen levels result in more bone loss. Other risk factors include family history of the condition, low body weight, low calcium diet, lack of physical activity, vitamin D deficiency, smoking, caffeine, alcohol, and early menopause or ovary removal prior to the age of 45.
When? Anyone experiencing some of the risk factors listed above should consult their doctor about having a bone density test.
How can I reduce my risk? Osteoporosis can prove crippling and even fatal in some cases. For seniors, hip fractures are a major issue: mortality increases significantly, less than 50% of those suffering a hip fracture achieve functional recovery, and many become permanently disabled. A healthy diet is a great way to avoid developing osteoporosis: eat foods high in calcium, including milk, salmon and sardines – don’t forget the bones! – beans, sunflower and sesame seeds, and broccoli. Physical activity strengthens bones, so keep active. And quit smoking: smokers experience faster rates of bone loss and are at more risk of fractures.
Blood Pressure Check
Why? Stroke and heart attack are among the leading causes of death in Canada. Every year, between 40,000 and 50,000 Canadians are hospitalized for strokes, with about 15,000 strokes proving fatal. In 2003, over 270,000 Canadians 12 years of age and older – yes, that’s 12 years of age, although the risk of stroke increases with age – were living with the effects of stroke. The risk of stroke doubles every 10 years after 55, and the condition affects men and women almost equally: 51% male, 49% female. The chance of a stroke sufferer having another stroke within two years is 20%.
Who should have it? Anyone with a family history of stroke or heart disease, and anyone
experiencing symptoms such as sudden numbness in the face, arm or leg, sudden vision problems, sudden severe headache or sudden speech problems. During a regular medical check-up, blood pressure will likely be monitored as a matter of course.
When? As soon as symptoms appear or as recommended by a doctor.
How can I reduce my risk? Don’t smoke; go for regular blood pressure checks; keep to a low-salt, low-fat diet; eat more fruit and vegetables and less fat; keep your weight down to a healthy level; and drink in moderation (no more than two drinks a day).
Chest X-ray
Why? By creating an image of the chest, heart, lungs, diaphragm, ribs and large arteries, a chest X-ray can reveal a number of problems, including an unusually shaped or enlarged heart, valve disorders or lung problems.
Who should have it? Anyone experiencing a persistent cough, chest pain or breathing difficulty, who is coughing up blood, or who has sustained a chest injury will likely be advised to have a chest X-ray. This simple test is also carried out when chest or lung diseases such as tuberculosis or lung cancer are suspected.
When? Consult your doctor immediately if you have any of these symptoms.
How can I reduce my risk? Smoking, lack of physical activity and highly polluted environments are all factors in heart and lung disease, so pack up the cigarettes, get moving and avoid unhealthy environments.
Electrocardiogram (ECG/EKG)
Why? An electrocardiogram, a simple, non-invasive test, measures the heart’s electrical activity. Problems that can be detected include abnormal heart rhythms (arrhythmias), blocked arteries, heart muscle damage, enlarged heart, or conditions such as electrolyte imbalances and lung disease.
Who should have it? Anyone who is experiencing arrhythmia, palpitations, dizziness or chest pains should consult their doctor about having an ECG.
When? As soon as symptoms occur.
How can I reduce my risk? Family history is indeed an influence, but as mentioned previously, smoking, excessive drinking, bad diet and lack of exercise are all major risk factors.
Cholesterol Test
Why? A cholesterol blood test is performed to determine the amounts and types of fats, including cholesterol and triglycerides, present in the bloodstream. If the levels of triglycerides, the most common form of fat in the body, are too high, they can adversely affect blood cholesterol levels. There are ‘good’ and ‘bad’ cholesterol, and plenty of information is readily available about the food sources of each. Elevated triglyceride levels are mainly linked with excessive alcohol, being overweight and poorly controlled diabetes. Cholesterol problems can lead to coronary artery disease, heart attack and stroke.
Who should have it? A cholesterol blood test is recommended for men over 40, women who are postmenopausal or over 50, diabetics, people with high risk factors such as hypertension, smoking or obesity, and those with a family history of heart disease or stroke.
When? Consult your doctor to discuss your risk level and preventative screening.
How can I reduce my risk? You must be getting the message by now. Here again, smoking, drinking and a high-fat diet are major risk factors.
Skin Cancer Check
Why? Skin cancer has been increasing at a steady rate in Canada over the past 30 years. In 2005, some 78,000 new cases of basal and squamous cell carcinomas (which develop slowly, are rarely fatal and usually do not spread) and some 4400 new cases of malignant melanomas were reported.
Who should have it? Anyone who notices any changes in moles, including colour, size, shape, bleeding or crusting, or any dark or discoloured spots or patches on the skin should contact their doctor.
When? As soon as possible.
How can I reduce my risk? Avoid tanning lamps and overexposure to the sun, keep in the shade whenever possible, apply sunscreen lotion with a factor of at least 15, never allow babies or young children to sleep in the sun or remain in the sun for long periods – even if they are wearing sunscreen, and encourage children and teenagers in the habit of applying sunscreen.
Dental Check-up
Why? Regular visits to the dentist can do a lot more than keep your smile at its brightest. Oral health is important to overall well-being because cavities and gum disease are linked to a number of serious conditions, including heart disease, diabetes, respiratory diseases, infection, and premature and low birth weight babies. Plaque build-up leads to tartar, which can lead to gum infections, which can lead to tooth loss and the more serious diseases listed.
Who should have it? Everyone! The good news here is that not only are we living longer: more and more seniors are keeping their own teeth longer as well. That’s because regular check-ups and treatments keep dental problems in check, can also lead to early detection of other problems, including oral cancer, and contribute to self-esteem and self-confidence.
When? Unless you experience a specific problem, you should have a dental check-up every six months.
How can I reduce my risk? Brush and floss regularly, eat healthily, quit smoking, and brush your children’s teeth for them until you are confident they are able to brush their own teeth properly under supervision.
Eye Test
Why? As we age, our vision changes. One of the most common effects is the ‘my arms aren’t long enough’ syndrome: in other words, difficulty reading small print. But some more serious conditions can result in severe vison problems and even blindness. These include cataracts, floaters, glaucoma, macular degeneration and diabetic retinopathy. Fortunately, cataract surgery has become commonplace and highly successful. But age-related macular degeneration can cause permanent loss of central vision, while glaucoma can result in total blindness if not treated in time.
Who should have it? If the eyes are the mirror to the soul, regular eye tests are the mirror to our general health. An eye test may well reveal that our glasses need changing, but it may also reveal serious conditions such as heart disease, high blood pressure and diabetes, as well as the eye problems listed above.
When? It’s important to have an eye test every year, especially after the age of 45.
How can I reduce my risk? Don’t smoke, and be sure to eat your carrots, as well as melons, spinach, kale and citrus fruits. Don’t strain your eyes by working or reading in a bad light, wear sunglasses in bright sunlight, and protect yourself from accidents by taking safety precautions, wearing safety glasses where necessary.
Hearing Loss Test
Why? Hearing loss can sneak up on us as we get older. It affects 30% of Canadians over 65, and 10% of Canadians in total. Although often minimized, dismissed and even ridiculed by many, hearing loss is a serious problem: it affects overall well-being because communication is curtailed, and can lead to social withdrawal, physical isolation and emotional problems such as depression.
Who should have it? As there are various types
of hearing loss, anyone experiencing difficulties should consult their doctor for advice because help is at hand for many problems.
When? As soon as difficulties appear, consult your doctor. A hearing test is recommended every two years, and don’t forget: if you are using a hearing aid and you are not satisfied with the results, go back and ask for help.
How can I reduce my risk? Inner ear hearing loss, which affects over 50% of Canadians, is usually irreversible. Some causes, such as noise damage from noise pollution – an increasing problem in today’s society – can be prevented. Be sure to wear some form of hearing protection when working in excessively noisy environments - and as unpopular as this will sound to many younger readers, simply avoid unnecessarily noisy environments such as rock concerts and some bars and night clubs. That advice might fall on metaphorically deaf ears today, but truly deaf ones in years to come!
Information compiled by Marilyn Arthurs
Sources: Health Canada, Canadian Cancer Society, Prostate Cancer Research Foundation
For more information, visit www.healthcanada.ca and click on the A-Z Index
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