“Why Preventative Screens are Necessary”
By Charlann Staab, CNP, AGACNP-BC
Even if you feel perfectly healthy, there are disorders such as hypertension, early cardiac disease and diabetes that could be causing damage to your organs before overwhelming symptoms are noticeable. Early detection is paramount to best practice and outcomes.
The annual physical provides a baseline health picture for you and your provider so that when you are ill, your provider understands the differences between your baseline and presentation (Duke Health, Michael Fedwa, Jr. DO ,2021). Preventative screens and wellness visits can reduce your risk for preventable health problems going unnoticed or becoming advanced prior to recognition (AARP, 2021)
What are the basic recommendations to screen for optimal health?
History & physical/medication reconciliation- annually to include height and weight- if BMI greater than 25 or known comorbidities every 6 months. (Cleveland Clinic.org 2021)
Eye exams can help identify risk for eye disease or early preventative care if you have Diabetes, Hypertension, Rheumatoid Arthritis, Kidney Disease annually. If no known or previous diagnosed health concerns, eye exams are recommended every two years
Regular Dental Checkups: Every six months to annually can help identify developing gum disease, tooth decay and overall poor oral health that if left unchecked can lead to an unhealthy immune system or complication with the lungs, heart and brain. Plaque that builds up on your teeth contains millions of bacteria and can lead to tartar which in turn produces an acid that erodes your tooth enamel and that leads to gingivitis. Gingivitis left unchecked can lead to periodontal disease that can breakdown the bones that support your teeth. What’s next? People can lose teeth which has a negative impact on digestion and nutrition leading to a widening group of complications including overall, poor health. Pregnant women, even with excellent dental hygiene are prone to develop gingivitis due to hormonal fluctuations and dry mouth disorder during pregnancy and may need to see the dentist more than every six months through the pregnancy.
Blood Pressure: Checked at least every 1- 2 years; undiagnosed hypertension can cause heart attacks, strokes, kidney ad eye problems. If you have known hypertension more frequent checks by your healthcare provider are necessary including weekly logs. If you are logging BP at home for a specific reason ( recent addition or change in medication) that you use the same equipment, on the same arm in the same position at the same time of day for consistent comparable readings.
Lung Cancer: If you are between the ages of 55 and 80, have a 30 pack per year smoking history (multiply the number of packs of cigarettes per day x the number of years you smoked), smoke now or within the last 15 years it is more important than ever to receive screening for lung cancer. Studies suggest this age range is the most common onset for cancer incidence for past and current smokers. Don’t discount the risk of second hand smoke contact either.
Breast Exam: Women that have a family history of breast, ovarian or peritoneal cancer may benefit from follow up and consider BRCA gene and genetic testing.
Cervical Health (GYN): starting at age 21, PAP smears are recommended every three years until 65 years of age (YOA) Women 30 years and older can alternate between PAP smear or HPV screening every 5 years until age 65. After 65 or if you have had a hysterectomy with ovaries removed you may not need additional screening.
Prostate Cancer – PSA: testing is recommended by age 55 however screening by age 40 if:
- One first degree relative had/has prostate cancer (father, brother or child)
- You have at least two family members extend family with prostate cancer
- You are African American, you are at great risk statistically
Osteoporosis: If post-menopausal screening should start no later than by age 65 with a DEXA scan. If you are younger and have had bone fractures, family history of osteopenia or osteoporosis you should also be scanned prior to age 65.
Colon Cancer: Between the ages of 50-75 screening should be initiated if no family history either with a stool testing kit or by colonoscopy. If you have a family history, colon cancer screening may start earlier depending on symptoms and type of cancer history.
Abdominal Aortic Aneurysm: MEN age 59 or older if every smoked.
Diabetes Mellitus (DM): you should be screening for DM if you have a family history, gestational DM history or if you have hypertension or take medication for hypertension. DM can cause damage to your eyes, heart, kidneys, feet and nerves BEFORE you know you have it.
Hepatitis C Virus (HCV): Recommended screening at least once if:
- Born between 1945 and 1965
- You have ever self-injected drugs
- You received a blood transfusion before 1992
High Blood Cholesterol: You should have regular periodic testing for blood cholesterol if:
- You use tobacco
- You are overweight
- You have a personal history of heart disease or blocked arteries
- You have a male relative who had a heart attack before 50 or a female relative prior to age 60.
- Currently on statin or cholesterol lowering drugs
Immunizations: CDC 2021 Update:
- Tetanus Td or Tdap every 10 years
- Flu shot annually
- If older than 60 consider shingles vaccine (Zoster RZV) One time vaccine.
- If older than 65 consider pneumonia vaccine PCV 13 or PPSV23 depending on underlying health conditions, it may be recommended that you receive both versions but 5 years apart. If you have heart or lung disease, diabetes, cirrhosis a cochlear implant, kidney failure, are taking cancer drugs, radiation or steroids, smoke or have asthma, the vaccine is recommended at a younger age.
- COVID vaccine
References: US DHHS 2014/ CDC 2021/AAFP 2019