The role of prevention.
A distinction must be made between “prevention,” broadly understood, and the more narrowly defined area of “preventive medical care.” Anything that can prevent a disease can be labeled prevention. Eating a proper diet, getting adequate exercise, losing excess weight, abstaining from smoking, drinking only in moderation and practicing proper sanitation are all examples of prevention. The medical literature has conclusively demonstrated that many individuals can avoid disease and premature death by choosing healthful eating and living habits.
In addition, public health efforts to provide clean drinking water and improve sanitation have been shown to prevent disease and promote longevity. In fact, according to some health experts, most of the increases in life expectancy over time have resulted not from advances in medicine but from improvements in public health.
Preventive medical care, on the other hand, is a much more narrowly defined concept. It includes regular exams and screening tests designed to catch a disease or a health problem before it has a chance to spread. Three kinds of preventive care are absolutely essential: prenatal care for poor women, tests in newborns for certain congenital disorders and most childhood immunizations.
Early detection of cervical cancer in women is possible through the use of a test called the Pap smear. The test involves taking cell samples from various parts of a woman’s cervix and studying them under a microscope for abnormalities that might indicate cancer so as to catch and treat it at an early stage. Regular screening is recommended because early detection can lead to lifesaving cancer treatment and because the test results are often inaccurate. For example, studies show that some 20 percent of cervical cancers are likely to be missed by a single screening test. However, as the figure shows, more frequent testing can be very expensive. It also can create “false positives” – incorrect indications that cancer is present – which typically lead to additional tests and, in some cases, unnecessary treatment. Over a lifetime, a woman is more likely to have a false positive than she is to get cervical cancer.
A newly developed blood test called prostate-specific antigen (PSA) can help in the early detection of prostate cancer, a leading killer of men. However, roughly 30 percent of prostate cancers pose no health threat whatsoever because the men who have them die of something else. Moreover, treatment may not prolong life.
It is conventional wisdom that detecting and treating high cholesterol prolongs life. After all, high levels of cholesterol have been linked with heart disease, another leading killer. Regular screening for the problem is a recommended part of any regimen of preventive care, with treatment – either in the form of a special diet or drugs – recommended for high levels of LDL cholesterol.
But not everyone with high cholesterol will suffer heart disease and the drugs used to treat the condition can have such side effects as gastrointestinal problems, a higher risk of gallstones and itching of the skin.
Of course, the fact that preventive care is not always cost-effective does not mean that it is wasteful. Diagnostic tests that show freedom from disease may relieve patients’ anxiety and reassure them of good health. Thus, for the most part, preventive care is like a consumer good that creates benefits in return for a cost. It is not like an investment good that promises a positive rate of economic return.
Breast cancer is the most common cancer among women (other than skin cancer) and large number of women are likely to die from it. Proper screening is imperative, because with many cancers symptoms usually don’t appear until the disease is in advanced stages–and that is too late.
Clinical breast exams should be a part of a yearly health exam for women between the ages of 20 and 39, and women must perform breast self-examinations, starting in their 20s.
Women should get any breast change promptly examined by a specialist. A vast majority of cancerous lumps are picked up by the patients themselves, if they are performing the self-exams religiously.
If you’re 40 or older, you should have a yearly mammogram. A mammogram is an x-ray of your breast tissue to detect breast lumps or suspicious changes that may be too small to be detected during a physical examination. If you’re at high risk for breast cancer, with a strong family history, it’s recommended that you discuss your family history with your doctor and start having mammograms earlier. The earlier breast cancer is detected, the greater a woman’s chance for survival. Remember, every woman is at risk for breast cancer, and the risk increases with age. But no woman has to die of breast cancer–a diagnosis does not have to be a death sentence.
Annual Pap smears and pelvic exams should begin after a woman reaches 18, or when she becomes sexually active, whichever occurs first. A Pap smear is a test that examines cells collected from the cervix to screen for cervical cancer and other abnormalities at an early and treatable stage. Annual Pap smears are especially important during a woman’s reproductive years. Healthy reproductive organs can help prevent problems during pregnancy and childbirth.
An additional next step is to be screened for common sexually transmitted diseases (STDs), which can cause infertility, and birth defects. The Human Papilloma Virus (HPV) is considered to be a major cause of cervical cancer, which is related to a woman’s sexual behavior. Practicing proper sexual safety precautions, such as using condoms or practicing abstinence, are highly recommended.
Unfortunately, all too often women wait too long to get proper medical attention. Good health is all about power–power of prevention and understanding that your health is in your hands. Challenge yourself to make the right decisions.
AGES 18 TO 39
AGES 40 TO 49
AGES 50 TO 64
AGES 65 AND OLDER
All children entering kindergarten or first grade should have a complete health exam within 90 days of entry and up-to-date immunizations. Health exams help identify health problems before they become more serious. The exam may be obtained as early as 18 months prior to first grade entry if your child is at least 4 years and 3 months of age.
Approximately one in ten children starting school have an unknown health problem, such as asthma, hearing loss, or vision loss. A comprehensive physical exam increases the opportunity to detect health problems early so that the conditions may be treated and long-term complications may be prevented. A healthy child does better in school!
Your child should have one exam during each of these age ranges:
Babies and Toddlers
School Children
Teenagers and Young Adults
A health checkup may also be given, when required, for sports, or camp.
A Health Exam for children includes:
Complete head-to-toe health exam may:
There are a number of tests required for routine medical examination. Some of these are listed below:
| Type of Test | Required for | Periodicity | Additional Points |
| Blood pressure check up | All adults | Annual | More frequent monitoring for those with BP of 135/85 or higher. |
| Cholesterol check | All adults | Annual after 30 years and more often if high LDL or low HDL or other risk factors | Obese and those with family history of heart disease may require more frequently. |
| Fasting blood glucose test | All above 40 and earlier for those at high risk | Annual | After age 30 for those with family history of diabetics. |
| Dental Examination | All adults | Every 6 months or as advised | Cleaning and screening for oral cancer also required. |
| Tetanus Diphtheria booster | All adults | Every 10 years | More regularly for aged above 50 |
| Hepatitis vaccine | All adults | As advised by physician | All newborns should be vaccinated |
| Chickenpox vaccine | All who have never had chickenpox | Once. But 2 shots are required for those above 13 years of age | Pregnant women should avoid. |
| Pap smear ( for early detection of cervical cancer) | All women over 18 & earlier if sexually active | Once every 3 years if earlier 3 annual tests are normal & more often for smokers and having multiple sex partners | May stop after 60 years of age |
| Breast cancer screening (mammography) | All women above 45 years | Annual | Self examination and clinical breast examination is also important |
| Colorectal cancer screening ( Fecal matter blood test, sigmoidoscopy, colonoscopy) | All 45 years age and above: earlier for those at high risk | Blood test annually, Sigmoidoscopy every 3-4 years and colonoscopy every 7-8 years or as advised by your physician | X-Ray with barium enema may also be done. |
| Thyroid disease screening | Women 50 years & above. Those with high cholesterol and family history of thyroid disease. | As advised by your physician or every 2-3 years | Ask your doctor about risk factors |
| Glaucoma screening | Diabetics and with family history of diabetics, Aged over 50, very nearsighted and suffering from sleep apnea | Bi-annual or as advised by your physician | Preferably all adults over 35 years of age |
| Chalmydia screening | Women 25 and younger, if sexually active | Annual or more often | Men & women of any age who are sexually active and at risk for sexually transmitted diseases. |
| Prostate cancer screening (prostate specific antigen)or PSA test and rectal exam | Those with family history after 40 years of age and others after 50 | Rectal exam annually & PSA on doctors advice | PSA screening only on advice. |
| Influenza vaccine | All aged 50 and above & those suffering from Lung/ heart disease or cancer | Annual | Even healthy younger adults should take it |
| Pneumococcal Vaccine | All aged 60 and above & others under high risk for complications | At least once | Lasts 5-10 years against most types of Pneumococcal pneumonia |
| Rubella Vaccine | All women of child bearing age | Once | Not to be taken during pregnancy |
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Someday may be genetic altering may improve immunity levels for disease but until then it is sensible to take adequate care and precautions.