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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.
Lipid profile
Blood sugar
Oral/dental
Vision/glaucoma
Thyroid panel
Colonoscopy
Mammogram
Bone density
Pap smear
HIV/AIDS
Prostate
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