Screening Tests All Women Should Take
Why Screening Tests Are Important
Getting the right screening test at the right time is one of the most important things you can do for your health. Screenings help find diseases like cancer or diabetes early, often before you have symptoms, and when they’re easier to treat. Which test you should have depends on your age and your risk factors. Learn more about the screenings your doctor may recommend for you.
Early breast cancer detection greatly improves your odds for survival. That’s because the smaller the cancer is when it’s found, the better the chance for a surgical cure. Smaller breast cancers are also less likely to have spread to lymph nodes and organs like the lungs and brain. If you’re in your 20s or 30s and don’t have known risk factors, a breast exam should be part of your regular health exam every three years. More frequent screening may be recommended if you’re older or have risk factors.
Screening With Mammography
Talk to your doctor about breast cancer screening. The American Cancer Society recommends yearly screening for women at average risk beginning at 40. However, the U.S. Preventive Services Task Force recommends routine screening mammograms every two years from ages 50 to 74. These low-dose X-rays often detect a breast mass before you can feel it. But a normal mammogram does not completely rule out the possibility of breast cancer.
The cervix is the part of the uterus that extends into the vaginal cavity. Persistent infection with the human papillomavirus (HPV) is the major risk factor for cervical cancer (shown here, magnified). Routine screening can find it early, when it’s highly curable. It can also find abnormal precancerous cells on the surface of the cervix so they can be removed before they turn into cancer.
Screening for Cervical Cancer
The Pap test checks for cancer of the cervix and abnormal cells that can occur before cancer develops. In the office, the doctor collects a sample of cells to examine in the lab. Testing should start at age 21, and repeat every three years. From age 30 to 65, some women can go five years between testing, if they get both a Pap test and a test for the HPV virus. These tests are very effective in both preventing cervical cancer and finding it early enough to cure it.
A Vaccine for Cervical Cancer
The FDA has approved a vaccine — Gardasil — for girls and women between the ages of 9 and 26. It protects them from four strains of HPV, the virus that is a leading cause of cervical cancer. A second vaccine, Cervarix, is approved for use in girls and women between the ages of 9 and 25, and targets two strains of HPV. Not all cervical cancers are due to HPV, and other strains of HPV can still cause cancer that neither vaccine protects against, so it’s still important to have routine Pap tests to screen for cervical cancer.
Osteoporosis and Fractured Bones
Osteoporosis is a condition in which bones become weak and fragile. It’s caused by bone loss, which accelerates in women after menopause. The first symptom is often a painful bone fracture that can occur with only a minor fall, blow, or even just a twist of the body. It is possible to both prevent and treat osteoporosis, which threatens about half of all women and one in four men in the U.S. aged 50 and over.
Osteoporosis Screening Tests
A test called Dual Energy X-ray Absorptiometry (DXA) can measure bone mineral density and detect osteoporosis before fractures occur. It can also help predict the risk of future bone fractures. Bone density testing is recommended for all women 65 years of age and older. It’s also recommended for younger women who have risk factors for osteoporosis.
The most dangerous form of skin cancer is melanoma (shown here). It’s a malignancy that affects the cells that produce pigment in the skin. Some people may have a genetic risk factor for melanoma. And the risk increases with overexposure to the sun and sunburn. Basal cell and squamous cell skin cancers are common non-melanoma skin cancers. Early treatment of skin cancer can be effective.
Screening for Skin Cancer
The American Cancer Society and the American Academy of Dermatology recommend regular skin self-exams to check for any changes in marks on your skin including shape, color, and size. A skin exam by a dermatologist or other health professional should be part of a routine checkup.
High Blood Pressure (Hypertension)
Your risk for high blood pressure increases with age. It’s also related to your weight and certain lifestyle habits. High blood pressure can lead to severe complications without any prior symptoms, including heart attack or stroke. Treating high blood pressure can reduce your risk of heart disease, stroke, and kidney failure. Finding out you have high blood pressure and then working with your doctor to manage it can pay huge health dividends.
Screening for High Blood Pressure
Blood pressure is expressed as two numbers. The first (systolic) is the pressure of your blood against your artery walls when the heart beats. The second (diastolic) is the pressure between beats. Normal adult blood pressure is less than 120/80. High blood pressure is at or above 140/90. A reading between those two is considered prehypertension. Your doctor can advise you as to how often to have your blood pressure checked.
A high level of LDL cholesterol is a major factor that increases the risk of atherosclerosis — hardening and narrowing of the arteries caused by plaque (seen here in orange). It can progress without symptoms for many years. Over time it can lead to heart attack and stroke. Other atherosclerosis risk factors are high blood pressure, diabetes, and smoking. Lifestyle changes and medications can lower your risk of heart disease.
Determining Cholesterol Levels
Doctors screen for problems with cholesterol by using a fasting blood lipid panel. That’s a blood test that tells you your levels of total cholesterol, LDL “bad” cholesterol, HDL “good” cholesterol, and triglyceride (blood fat). Management decisions are based on the results. For adults 20 years or older, you should have a new panel done at least every five years.
Type 2 Diabetes
One-third of the people in the U.S. with diabetes don’t know they have it. The seventh leading cause of death in the U.S., diabetes can lead to a vast array of complications such as heart disease and stroke, kidney disease, blindness from damage to the blood vessels of the retina (shown here), and nerve damage. But, especially when found early, diabetes can be controlled and complications avoided with diet, exercise, weight loss, and medication.
Screening for Type 2 Diabetes
The fasting plasma glucose test is often used to screen for diabetes and prediabetes. Blood is drawn after you’ve fasted at least eight hours. A blood sugar level of 100 to 125 indicates prediabetes. And 126 or higher may indicate diabetes. Other diabetes screening tests include the A1C test and the oral glucose tolerance test. If you’re healthy and have a normal diabetes risk, you should have a screening test every three years starting at age 45. If you have a higher risk, get tested earlier and more often.
Human Immunodeficiency Virus (HIV)
HIV is the virus that causes AIDS. It’s in the blood and other body secretions of infected individuals, even when there are no symptoms. It can spread from one person to another when fluids come in contact with the vagina, anal area, mouth, eyes, or a break in the skin. There is still no cure or vaccine. But, early treatment with anti-HIV medications may help the body’s immune system fight the virus.
HIV Screening Tests
HIV-infected individuals can remain symptom free for many years. The only way to know they are infected is with a series of blood tests. The first test is called ELISA or EIA. It looks for antibodies to HIV in the blood. It’s possible not to be infected and still show positive on the test. So a second test called a Western blot assay is done for confirmation. If you are infected, you could still have a negative test result. Repeat testing is recommended. Teens and adults at increased risk should be screened for HIV.
Preventing the Spread of HIV
Most newly infected individuals test positive by two months after infection. But in rare cases it may take up to six months for an ELISA test to turn positive after exposure to HIV. Abstinence or using latex barriers such as a condom or a dental dam is necessary to help avoid potential infection of HIV and other sexually transmitted infections. If you have HIV and are pregnant, talk with your doctor about what needs to be done to reduce the risk of HIV infection in your unborn child.
Importance of Health Screening
Being proactive and discussing screening tests with your doctor makes good health sense. Some tests, such as a Pap test or breast exam should be a routine part of every woman’s health care. Other tests become more or less important based on your risks. Proper screening won’t always prevent a disease. But it can often find a disease early enough to give you the best chance of overcoming it.