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Tuesday, Nov. 14, 2023

Keeping in Top Condition


Importance of Screening Tests and Preventative Care Visits

Everybody desires a healthy and long life. Not only is eating a nutritious diet important, but so is completing routine screening tests. In a preventative care visit, a primary care provider can guide patients to keep their health in excellent condition by offering screening tests and, in some cases, prolonging life by detecting cancer at an early stage. There are several screening tests that a primary care provider can offer during the yearly visit.

In the United States, the two most common chronic conditions are essential hypertension and diabetes mellitus. Essential hypertension slowly damages the kidneys and causes cholesterol build-up in the blood vessels; it is a silent killer. Atherosclerosis, which is a build-up of cholesterol in your blood vessels, can cause sudden heart attacks, stroke in the brain and peripheral arterial disease in the legs. It is essential to get a yearly screening blood pressure check if you are 18 or older.

Essential hypertension is diagnosed when blood pressure is more than 140/90 in two separate office visits, as your blood pressure goal should be around 120/70. In the case of systolic blood pressure (first number), between 100 to 120 is normal, and 120 to 139 is prehypertension and stage 1 hypertension. For diastolic blood pressure (second or bottom number), 60 to 80 is normal, and 80 to 89 is prehypertension and stage 1 hypertension. If your blood pressure constantly runs more than 140/90, you should seek help from a primary care provider.

Besides essential hypertension, it is also vital to obtain yearly diabetes screening if you are more than 35 years old and obese, with a BMI of more than 25. Uncontrolled diabetes causes kidney damage (diabetic nephropathy), eye problems (diabetic retinopathy) and nerve issues (peripheral neuropathy).

Both uncontrolled diabetes and uncontrolled hypertension can put you in danger of dialysis. Through routine yearly preventative screening checks, a primary care provider can identify if you are prediabetic or diabetic and help you modify your diet and lifestyle. Through modifying lifestyle, doing more exercise and eating a low carbohydrate and low sugar diet, it is possible to slow the progression from prediabetes to diabetes.

Besides the two chronic conditions discussed above, a primary care provider can offer other screening tests to detect cancers early. According to the American Cancer Society, the most common cancer and cancer-related death in women is breast cancer. In 2023, about 297,790 women were diagnosed with breast cancer and roughly 43,170 women died from it. The United States Preventative Task Forces (USPSTF) recommends that women between ages 50 and 74 should get a mammogram every two years. The American Cancer Society recommends an annual mammogram for patients between 40-49 to detect any breast cancer early.

In men, lung cancer and colorectal cancer are the second and third most common cancers in the United States. In 2023, about 238,340 people were diagnosed with lung cancer, and approximately 127,070 people died from it. Therefore, a patient who is between 50 and 80 years old with a history of smoking 20 cigarette packs per year and is currently a smoker or has quit smoking in the last 15 years needs a yearly chest CT to detect cancer at the early stage.

The third most common cancer and cancer-related death in the USA in 2023 is due to colorectal cancer. In 2023, about 153,020 people were diagnosed with colorectal cancer, and roughly 52,550 people died from it. It is recommended that patients between 45 and 75 years old should get a colon cancer screening test. Colon cancer screening tests can be done in three ways. Patients can get a colonoscopy every 10 years if the initial colonoscopy results are normal. If patients do not want colonoscopy, they can choose stool tests, which include a Cologuard test every three years and a FIT test annually. While colonoscopy has high accuracy, the Cologuard stool test is also about 93% accurate in detecting colon cancer.

Women may also develop cervical cancer.

Therefore, the USPSTF recommends that women between 21-29 years old should get a Pap smear every three years and women between 30-65 years old should get a Pap smear and HPV testing every five years.

Depending on age and medical conditions, a yearly blood test to monitor kidney and liver functions can detect disease early. To live a healthy life, completing routine preventative tests is key to keeping us healthy. Therefore, it is recommended that you schedule at least one yearly visit with your primary care doctor and discuss which preventative tests are recommended for your age and complete those tests at your convenience.

Kabiul Haque, MD, MPH, is an assistant professor of family medicine at LSU Health Shreveport.

Table 1: Summary of Screening Tests with Age Recommendation Blood pressure screen on each office visit Greater than 18 years old.

Diabetes screening Greater than 35 years old and BMI more than 25.

Lung cancer screen 50-80 years old, smoked 20 packs per year and currently a smoker or quit smoking in the last 15 years. Screen test: low dose CT scan of lungs.

Breast cancer screen 50-74 years old, a mammogram every two years

Cervical cancer screen 21-29 years old, every three years Pap smear. 30-65, either every three years with a Pap smear or every five years with additional testing in addition to a Pap smear.

Colon cancer screen 45-75, every 10 years for colonoscopy, Cologuard stool tests every three years, and FIT stool test every year.

Eye exam All diabetic patients should check for diabetic retinopathy.


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