NASE News

Screening Tests Can Save Your Health (And Maybe Your Life)

It wasn’t long ago that most Americans had never even heard the word colonoscopy. Now the test for early detection of colon cancer is a buzzword, thanks to the awareness campaign by TV personality Katie Couric after her husband died of the disease.

Nobody enjoys going in for medical tests—especially ones that involve minor embarrassments or encounters with needles. But putting up with a little inconvenience means uncovering health problems early, while they’re easier (and cheaper) to solve.

And early detection can make the difference between life and death.

This report will give you the facts on common tests adults need:

  1. Lipid profile
  2. Blood sugar
  3. Oral/dental
  4. Vision/glaucoma
  5. Thyroid panel
  6. Colonoscopy
  7. Mammogram
  8. Bone density
  9. Pap smear
  10. HIV/AIDS
  11. Prostate
  12. Abdominal aortic aneurysm
We explain the purpose of each test, when to have it and ballpark costs, although prices vary widely across the U.S.

1. Complete Lipid Profile
This blood test measures total cholesterol as well as “good” (HDL) and “bad” (LDL) cholesterol and triglycerides (fats).

Why: Levels of total cholesterol and LDL are correlated to risk for coronary heart disease and stroke, but the higher your HDL, the better.

When: The American Heart Association recommends that tests begin at age 20 and be repeated every five years. You may need more frequent testing if you have diabetes or high blood pressure, you smoke, or heart disease runs in the family.

Cost: $50 to $75.

2. Blood Sugar
Blood is drawn and the level of glucose (sugar) measured.

Why: High blood sugar may indicate the presence of diabetes—or that the patient is at risk of developing the disease.

When: The test should be performed at age 45 and then every three years. People who are obese or have high blood pressure and high blood cholesterol should be tested earlier.

Cost: $25.

3. Oral/Dental Exam
In addition to cleaning your teeth and checking for cavities, a dentist will look for periodontal (gum) disease and abnormalities such as growths and sores.

Why: Gum disease is a major cause of tooth loss, and 75 percent of head and neck cancers begin in the mouth and throat, reports the Oral Cancer Foundation.

When: Every six months.

Cost: $75 to $150.

4. Vision/Glaucoma
Regular eye exams ensure that prescriptions for glasses and contact lenses are up to date—but also typically include the use of a noncontact tonometer, a device that gives a “puff-of-air” test.

Why: The test indicates the level of pressure within the eye. Overly high pressure can develop into glaucoma and ultimately blindness.

When: The American Academy of Ophthalmology recommends a glaucoma test at age 20 for most patients. People in their 20s should have at least one eye exam and those in their 30s, at least two. From age 40 to 64, schedule an exam every two to four years. People 65 or older should have one every year or two. Those who have increased risk of glaucoma should be tested annually. High-risk populations include people over age 65; African-Americans; people of East Asian ancestry; patients who have had an eye injury or eye surgery; those who have taken corticosteroid medicines; and those who have diabetes, high blood pressure or a family history of glaucoma.

Cost: $50 to $175 or more.

5. Thyroid Panel
A blood sample is tested for levels of several substances related to thyroid function.

Why: Untreated thyroid disease is correlated to high cholesterol, heart disease and ovarian cancer. Low thyroid levels (hypothyroidism) can cause fatigue, depression, weight gain and other problems. High levels (hyperthyroidism) are associated with weight loss, insomnia and anxiety. Medication—or in some cases surgery—may restore normal function.

When: The American Thyroid Association recommends testing at age 35, then every five years.

Cost: $50 to $75.

6. Colonoscopy
Using a thin, flexible tube fitted with a video camera and a light, a physician can examine the entire colon, the last section of the digestive tract.

Why: The test reveals the presence of colon cancer or abnormal growths called polyps, which can become malignant. Colorectal cancer is the second leading cause of cancer deaths, yet is highly preventable if polyps are removed early.

When: Have the test at age 50, then every 10 years.

Cost: $500 to $1,000.

Another and much cheaper—but also less accurate—screening is the fecal occult blood test (FOBT), which detects hidden blood in stool. As with colonoscopy, testing should start at age 50. FOBT should be performed annually. The cost is typically $25 or less.

7. Screening Mammogram
This low-dose X-ray pinpoints abnormalities in women’s breast tissue.

Why: Mammograms can indicate the presence of cancer as much as two years before a patient or her doctor could feel a lump.

When: Women should have a mammogram every one to two years, starting at age 40.

Cost: $100 to $150.

In addition, every three years women in their 20s and 30s should have a clinical breast exam (CBE), in which the doctor examines each breast manually. Women over 40 should have the exam annually. CBE is usually part of a woman’s routine annual physical.

8. Bone density
A doctor or technician performs a dual energy X-ray absorption (DEXA) scan to determine the bone-mineral density of the patient’s spine and/or hip bones.

Why: Low bone density is correlated to risk of fractures, but prescription medicine can often slow or reverse bone loss.

When: Women should be tested at age 65—earlier if osteoporosis runs in the family or if you are very thin, are a smoker, or have a history of broken bones. Patients who have used long-term courses of prescription steroid drugs are also at greater risk of osteoporosis. After the initial test, your doctor will determine whether or how often additional DEXA scans are needed.

Cost: $250 to $350.

9. Pap Smear
The test collects cells from a woman’s cervix, the narrow end of the uterus, and the cells are examined under a microscope.

Why: Abnormalities could indicate a precancerous condition or cervical cancer.

When: Women between the ages of 21 and 65 who have ever been sexually active should have a Pap smear every one to three years. The Mayo Clinic advises that women age 70 or over may stop having Pap smears if they have had normal results three tests in a row and no abnormal results over the previous 10 years.

Cost: $50 to $65.

10. HIV/AIDS
Blood is tested for antibodies that indicate infection with human immunodeficiency virus (HIV). AIDS, or acquired immunodeficiency syndrome, is the final stage of HIV infection.

Why: Early detection can mean preventing the development of AIDS for many years with a regimen of prescription drugs.

When: It’s wise to be tested if you had a blood transfusion between 1978 and 1985; use or have used injection drugs or had sexual partners who injected drugs; or have had sex with a man who has had male sex partners. Also, the U.S. Centers for Disease Control recommends that all pregnant women be screened. Many doctors perform HIV screening as part of routine blood work unless the patient declines the test.

Cost: $25 to $100. Clinics in some communities offer free tests.

11. Prostate-Specific Antigen (PSA) Test
A blood test for men indicates the level of PSA, a protein produced by the prostate gland.

Why: High PSA levels may indicate prostate cancer or benign inflammation or enlargement of the gland. Prostate cancer affects one in six men but is highly curable with early detection.

When: Men should have a PSA test every year starting at age 50. The doctor will also usually perform a digital rectal exam, which enables him to feel lumps or abnormalities of the prostate through the rectal wall.

Cost of PSA: $50 to $100.

12. Abdominal Aortic Aneurysm (AAA)
Using ultrasound, the test screens for the presence of an abnormally large or swollen blood vessel in the abdomen of men.

Why: If such an aneurysm bursts, severe internal bleeding can cause death. Caught early, AAA can be treated or cured.

When: Men between the ages of 65 and 75 who have smoked more than 100 cigarettes in their lifetime should be tested once.

Cost: about $150.

Encourage Employees To Get Tested
When it comes to private matters like health tests, individuals have to take personal responsibility. But as an employer, you can encourage staffers to make good choices.
  • Be aware that employees may need to schedule routine health tests during business hours. Be flexible so employees can take time off to get the tests they need.
  • Talk up news stories that cover the importance of routine tests or post articles on a company bulletin board.
  • Send out periodic memos that tell employees what tests your health plan covers.
  • Stay in touch with your insurance provider, which may offer employees newsletters and other information on preventive care.
  • Publicize reduced-cost health services—for example, flu vaccinations offered by the local health department or mobile mammogram clinics that may give price breaks.
Even such simple efforts could save a life.

For More Information
To learn more, visit these government-sponsored Web sites.

The Centers for Disease Control’s Healthy Living section Many resources on preventive care, including details on screenings for cancer, bone health, sexual health and more cdc.gov/HealthyLiving

The National Institutes of Health, consumer site A cornucopia of authoritative information and current research on all aspects of health and wellness www.health.nih.gov

The U.S. Department of Health and Human Services’ women’s health page Provides information on recommended tests for both men and women www.womenshealth.gov/screeningcharts