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Medical Testing: What's Really Necessary?
Driving home, you hear an ad for cardiac screening. At lunch, a colleague talks about his PSA test. Your doctor reminds you that you should schedule a mammogram. As you get older, it seems that you are bombarded by information about medical testing. But what do you really need to do?
Among the most effective health-care moves you can make is to have a personal physician whom you see regularly. Armed with specific information about you and your medical history, your doctor can recommend the screenings you need. In addition, your doctor can interpret any tests you have in the context of your overall health history. This is the best way to protect yourself against health problems.
If you are just beginning to give this serious thought, start by making sure blood pressure and cholesterol tests are a part of your annual physical exam. Controlling blood pressure and cholesterol, as well as other risk factors such as smoking and excessive weight, are critical to preventing heart attacks and strokes.
The United States Preventive Services Task Force discourages low-risk adults from routine tests such as electrocardiography, treadmill testing or computerized tomography (CT) tests. The task force says that any benefits from such testing do not outweigh the risk, such as additional testing caused by false positives, or incorrect diagnoses of a heart condition.
The American Cancer Society (ACS) offers screening recommendations for several common cancers. If you are at increased risk for any of these cancers, you should talk to your doctor about starting the screenings earlier. For low-risk people though, the ACS suggests the following time frames:
- Breast cancer: Women should get yearly mammograms starting at age 40. As part of a regular physical exam, the doctor should perform a clinical breast exam every two to three years from age 20 to 40, and every year after 40.
- Colon cancer: Starting at age 50, everyone should follow one of five testing schedules; yearly fecal occult blood test (FOBT) or fecal immunochemical test (FIT); flexible sigmoidocsopy every five years; yearly FOBT or FIT plus flexible sigmoidoscopy every five years; double-contrast barium enema every five years; or colonoscopy every 10 years.
- Prostate cancer: Starting at age 50, men should have both a prostate-specific antigen (PSA) test and a digital rectal exam annually.
- Cervical cancer: Women should start no later than age 21 with annual pap tests or newer liquid-based pap tests every two years. Beginning at age 30, if a woman has had three normal pap tests in a row, she can increase her screening frequency to once every two to three years.