As a young female or one that might be in the midst of childbearing, doctors visits are plenty. But what happens in our middle age years? There are important health screenings that every woman should be getting. Knowing what to expect and when will help keep you on track to know when you need to make that next in-person appointment.
Men and women have some of the same preventative health needs, but also some distinct tests and screenings. Some providers suggest that if you are under the age of 49 years and have no chronic illnesses or ongoing health issues or concerns, you only need a checkup every three years. If you have any health issues or are 50 years old or older, this suggestion increases to yearly visits.
Screenings are dependent on a few things. Some are related to age and lifestyle but others have to do with your past health history and that of your relatives. Let’s hope Grandma lived long and healthy! Talk to your provider about what is most appropriate for you. Routine health screenings can be different for everyone but one thing to keep in mind is that these tests, screenings and lifestyle changes are meant to help prevent disease! Don’t delay care.
What health screenings do women need and when?
Breast screening is extremely important for early detection of breast cancer. The mammogram is now thought to be the best screening test to detect breast cancer early. The CDC reports that while knowing your breasts, doing self exams, and getting routine clinical breast exams in the doctor’s office can be helpful in the early detection of abnormalities, it does not lower the risk from dying of breast cancer. It is important to talk with your provider about when is most appropriate for getting a mammogram.
A mammogram is an X-ray of the breast and the best way to detect breast cancer early. Regular mammograms can lower your risk of dying from breast cancer due to early detection. This test is recommended every one to two years depending on who you ask: the National Cancer Institute advises all women age 40 and over to have a mammogram every one to two years, while the American Cancer Society recommends yearly mammograms starting at age 40 and continuing for as long as a woman is in good health. Whichever way you go, getting a mammogram every one to two years is the key to early detection.
Those with family history, dense breast tissue, or other risk factors should discuss when screenings should start. For example, if your mother or sister was diagnosed with breast cancer at a young age, oftentimes you may be recommended to have yearly mammograms starting a few years before the diagnosis of your affected family member. Den’t delay care! Early detection of any potential issues is best for optimal health.
The American College of Obstetricians and gynecologists (ACOG) recommends getting screened for cervical cancer at age 21 and then every three years thereafter. Screening starts with a pap smear to look for abnormal cells, as well as a Human Papilloma Virus (HPV) test, which checks for the HPV virus present in 99% of cervical cancer cases. An abnormal test result does not diagnose cervical cancer but can detect precancerous cells or presence of the virus that will prompt more testing and biopsies of the cervical tissue. Getting checked regularly is very important for early detection of cervical cancer.
Screening for osteoporosis should start at age 65. Oftentimes there are no obvious signs of osteoporosis until you fracture (break) a bone. If you have a bone break at an early age that doesn’t involve trauma or a high fall, earlier testing is usually recommended.
Screening for osteoporosis involves getting a bone density test (DXA) of the hip or spine. This test is like an X-ray and the only test that will determine if you have osteoporosis by detecting how dense your bone is. The test can help predict how strong your bones are and if you need any special precautions, or need to take any supplements or medications to strengthen your bones.
Screening for type 2 Diabetes is done by simple lab tests:
- Hemoglobin A1C is a test that determines your average blood sugar over the last two to three months. This is a nice test to see how your blood sugars have been over time.
- A fasting glucose test measures how much sugar is in your blood at the time of the test, after not having anything to eat overnight.
Both tests can indicate if you have normal levels, prediabetes or diabetes. Knowing how your sugar levels have been and how they are with no food on board will indicate if you need a lifestyle change or medication to manage your sugar levels. Type 2 diabetes often has no symptoms and with early detection, you can minimize any long term complications.
The American Diabetes Association (ADA) recommends that adults age 45 and older get screened for type 2 diabetes every three years by their health care provider. More frequent screening is recommended if you are overweight and have any risk factors including:
- Family history of diabetes
- Sedentary lifestyle
- African-American, Hispanic-American, Native-American, Asian-American, or Pacific Islander ancestry
- History of blood glucose problems
- History of gestational diabetes or a baby weighing over nine pounds
- High blood pressure
- Cholesterol problems
- Polycystic ovary syndrome
- History of vascular disease
Some groups suggest that starting screening at a younger age has benefits, but the American Association of Clinical Endocrinologists recommends that high-risk adults get screened annually beginning at age 30. Discuss these important and simple health screening tests with your provider, especially if you have any risk factors.
This is especially important for women who were diagnosed with gestational diabetes (diabetes while pregnant). Although gestational diabetes goes away after giving birth, this diagnosis can increase your overall risk of developing type 2 diabetes in your lifetime. According to the CDC, about 50% of women with gestational diabetes go on to develop type 2 diabetes.
It’s important to know that diabetes increases the risk of heart disease (the most common diabetes complication) by about four times in women but only about two times in men. Women also have worse outcomes after a heart attack. Woah, time to get that screening!
Blood pressure measures the pressure in your arteries as your heart pumps blood to the body (circulation). It is important that these numbers are within normal limits to keep your heart from being stressed. High blood pressure is when these numbers are consistently too high. Having high blood pressure that is consistent can damage your circulatory system and put you at risk for heart attack and stroke (heart disease).
Getting blood pressure checked yearly is recommended for all adults, even with a history of normal blood pressures. Talk to your provider to see if you can do this at home, or you need to come into the office for a blood pressure check each year. If you have a history of high blood pressure or have any risk factors such as obesity, diabetes, high cholesterol, alcohol use, older age, high salt diet, or a sedentary lifestyle, then it is recommended to have your blood pressure checked twice per year.
People with high blood pressure usually will need a yearly checkup to be sure there are not any other complications being caused by the high blood pressure, and that the high blood pressure is not getting worse.
Cholesterol is a waxy-fatty substance found in the blood and in the cells of your body. Your liver makes cholesterol and you also get it from foods that you eat. A cholesterol test determines how much cholesterol and the types of cholesterol in your blood. There are two main types of cholesterol: low-density lipoprotein (LDL), which is sometimes called “bad” cholesterol, and high-density lipoprotein (HDL), or sometimes called “good” cholesterol. A cholesterol test will measure your total amounts of cholesterol as well as both the LDL and HDL.
Abnormal levels of these types of cholesterol can determine your risk for having buildup of plaques and blockages in your arteries and indicate higher risk for heart disease. Heart disease was once thought to be more common in men but almost as many women die of heart disease each year as men. In fact, heart disease is the leading cause of death for women in the United States, killing 299,578 women in 2017—or about 1 in every 5 female deaths according to the CDC.
The American Heart Association recommends that all adults 20 or older have their cholesterol and other traditional risk factors checked every four to six years. This may be done more frequently depending on your health history and family history, so be sure to discuss this plan with your provider. After age 40, risk can increase and your provider can calculate this risk based on your medical history, as well as determine how frequently you need your cholesterol checked.
Cancer of the colon or rectum is called colorectal cancer, or colon cancer for short. It is important to screen for colorectal cancer as risk increases as you age and can come with minimal symptoms. Polyps are usually the first sign of a problem, and with screening, can oftentimes be removed before they have become cancerous. It is suggested to have colorectal cancer screening after age 50 and then regularly thereafter.
The type of test and frequency can be discussed with your provider based on your health history and family history of colorectal cancer, as well as overall risk. Those with family history or those found to be at higher risk will have screenings at a younger age. Screening is very important with any risk factors, as there has been an increase in this type of cancer by 2% each year from 2007 to 2016 in those younger than 55 according to American Cancer Society. They also state that the lifetime risk of developing colorectal cancer is about 1 in 23 (4.4%) for men and 1 in 25 (4.1%) for women, making it important for both men and women to think about.
Testing comes in different forms. Depending on your risk, history and age you may need one or all of the following tests:
- Stool test: Either a smear of stool (poop) or a full bowel movement to test for any tiny blood that isn’t visible to the naked eye. Blood in the stool can indicate a problem with the colon and will trigger more testing. This can be done in the office or can be mailed in and should be done yearly.
- Flexible sigmoidoscopy: Your provider will put a short, thin, flexible, lighted tube into your rectum to check for polyps or cancer inside the rectum and lower third of the colon. This test can be done every 5-10 years based on your results, history, and frequency of other stool tests that you may be getting.
- Colonoscopy: This is similar to flexible sigmoidoscopy, except a longer, thin, flexible, lighted tube is used to check for polyps or cancer inside the rectum and the whole entire colon. During the test, the doctor can find and remove most polyps and some cancers. Colonoscopy also is used as a follow-up test if anything unusual is found during one of the other screening tests. This is usually done as a day procedure with some sedation or general anesthesia every 10 years (and more frequently if you have risk or family history of colorectal cancers).
Screenings versus diagnostic testing: why preventive screenings are important
Health screenings can seem overwhelming, but remember: the purpose of a screening is to look for a disease before symptoms appear, so they are important to get scheduled on the calendar. Diagnostic testing is then used once a person has symptoms. Screening is an important part of healthcare because the ultimate goal is to keep you healthy before a problem arises. Screening tests give providers a jump start on your health. As a patient, your job is to make good lifestyle choices that decrease your risks of disease for a healthy life!
A healthy lifestyle includes how you feel mentally and physically. Caring for your mind and body are both important. Be sure to talk with your healthcare provider about your mental health too. Eating a healthy diet, exercising and taking time for your mental health are all important in a healthy body. Feel free to chat with a nurse first with any concerns or questions and make sure you have that checkup appointment on the calendar. Remember to check out our general health screenings article and our men’s health screenings article for those males in your life to be sure you aren’t missing anything important for optimal health.
The opinions expressed in Nurse-1-1 Health Center Blogs are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.