Here's the deal. Staying healthy isn’t limited to eating right, exercising regularly and getting adequate sleep. To detect and prevent certain life-threatening conditions and ensure that your health is on the right track, it’s important to undergo medical screenings throughout your lifetime.
Dr Malini Munisamy, a general practitioner at Onecare Medical says that a general health screening includes a battery of tests. “Most clinics offer a standard health screening package, which typically includes a blood test, X-ray, ECG (echo cardiogram), and other tests. As part of your clinical examination, your height, weight and Body Mass Index (BMI) are measured, and your blood pressure and cholesterol levels, checked. To screen for diabetes, you may also have to undergo a fasting blood sugar test; other tests may include a kidney function test, a liver function test, a urine test, and a stool test.” According to Dr Munisamy, these are the most important health screenings for women:
What it is: A Pap smear screens for abnormal cellular changes in the cervix. These changes are caused by the HPV (human papillomavirus), of which certain strains can cause cervical cancer. A Pap smear alone does not detect this virus.
When to do it: From 21 years old if you’re sexually active. Regular pap smears should be done every two years until the age of 30, after which they should be done every three years until the age of 65. If your last Pap smear results were abnormal then the test may be done more frequently (depending on the abnormality).
If you’re also getting a HPV screening along with a Pap smear then you can get this co-test every five years (provided your previous results were normal). HPV screenings alone should not be done for women under the age of 30.
If you’ve had a total hysterectomy (removal of your womb and cervix) due to non-cancerous reasons, you need not continue your Pap smear after 65, provided you’ve had regular and normal Pap smears and no evidence of CIN2 (a rating to describe moderately abnormal cells) or higher within the last 20 years.
If your uterus was removed due to cancer, or you have a history of precancerous cervical cells, your Pap smears should be continued beyond the age of 65.
Up until the age of 25, you can get the cervical cancer vaccine (Gardasil and Cervarix). However, Dr Munisamy says that you’ll still have to continue with Pap smears, since the vaccine only protects against two of the most common cancer-causing HPV strains – HPV 16 and 18 – but not the rest.
What it is: Mammograms are low-dose X-rays that can help detect changes in breast tissue and thus, detect breast cancer early. Whether or not you’re old enough to have a mammogram, Dr Munisamy says that you should do a self- breast examination every month.
When to do it: Routine screenings are recommended from the age of 50. If you’re at an average or low risk of developing breast cancer, you should undergo mammograms annually from the age of 40 to 49, and, from 50 to 72, you should undergo clinical breast examinations annually as well as mammograms annually.
If you have a strong family history of breast cancer – for instance a first-degree relative like your mum, sister or daughter has the disease – or the BRCA gene mutation was present in your family screening, or if you have a lifetime risk of 20 to 25 per cent of developing breast cancer based on risk assessment tools, you need to start having mammograms and breast MRIs (magnetic resonance imaging) early – by the age of 30, says Dr Munisamy.
What it is: The most common hormonal test done on women is the thyroid function test. Dr Munisamy says that this test helps screen for hypo- and hyper-thyroidism.
“Thyroid hormones are secreted by the thyroid gland, which is located at front of the neck,” she explains. “Thyroid hormones control a wide range of functions in the body, like our metabolic rate and so on. Women with an underactive thyroid gland may present symptoms like weight gain, cold intolerance, a low heart rate, a hoarse voice, fatigue, mental dulling, thinning of hair, menstrual irregularities, and a low mood. If you have a hyperactive thyroid, you may experience tremors, excessive sweating, irritability, weight loss, and heart palpitations.”
She continues: “Thyroid hormone dysfunction can be treated with medications. Patients who do not respond to medications may need surgery to remove the gland.”
When to do it: Hormonal tests are not usually done routinely, except when symptoms are present.
Bone mineral density test
What it is: A bone-mineral density test or the DEXA (dual energy X-ray absorptiometry) scan of the hips and spine screens for osteoporosis, a condition whereby the bones lose density and undergo micro architectural changes, leading to fractures, says Dr Munisamy.
Risk factors for osteoporosis include cigarette smoking, alcohol abuse, low calcium intake, lack of regular physical activity, and prolonged immobilisation. However, Dr Munisamy says that these factors are modifiable.
When to do it: This screening isn’t necessary until you turn 65. Under-65s should only be screened if they’re deemed to have a high overall fracture risk (based on risk assessment tools).