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Saturday, December 1, 2007 

Recommended Routine Health Tests

We have been taught that the body needs 'routine maintenance', like a machine - a car, for example. However, medical experts have debunked the virtues of routine medical tests. The drawback of the tests conducted at present is that a large number of "false positives' crop up. Not only does an abnormal test result create a lot of anxiety and stress but also leads to a merry-go-round of further tests and consultations to determine the significance of the tests. For example, consider the PSA (prostate-specific antigen) test that measures the level of a specific protein in the blood to detect cancer and other prostate abnormalities.

An elevated level of PSA is not diagnostic of prostate cancer. We may be unnecessarily subjecting a number of patients who are otherwise normal but have elevated PSA levels. Then, to verify that they are suffering from prostate cancer, they will be subjected to a prostate biopsy, and sometimes even surgery to remove the prostate altogether. The experts also debate whether current technology can tell a slow-growing cancer from a fast one (about 1 in 4 is slow growing and may not cause any trouble), and how a man?s life expectancy may never be affected by the cancer but by the treatment?s side effects.

The Task Force recommends a more selective and personalized approach tailored to individual needs. If you are worried about your health, consult a physician who should take a detailed medical history to identify anything that may put you at high risk for a specific disease or disability - any occupational and behavioral factors that affect health, eating habits, use of alcohol tobacco and other drugs, and sexual activity. Using that knowledge, physicians can zero in on preventive strategies targeted for you, omitting tests that are of little benefit to you.

The only routine tests that the US Preventive Services Task Force recommends are those for blood pressure, cholesterol, colorectal cancer, breast cancer and cervical cancer. The Task Foce also criticizes physicians for frittering away their valuable time on screenings of questionable value instead of counseling people about the harmful effects of smoking, lack of exercise and other risks arising due to a faulty lifestyle.

Keeping in mind the suggestions of the task force, the recommended tests are:

1. Periodic check-up of blood pressure, a leading risk factor for coronary heart disease, stroke, renal disease and heart attack, for all adults.

2. Periodic tests for total blood cholesterol measurement, another risk factor for heart diseases, for men between the ages of 35 and 65 and women 45 to 65.

3. Mammogram to detect early signs of breast cancer for women between 50 and 69, every one or two years.

4. The PAP smear test , to screen for cervical cancer, for sexually active women, once every three years.

5. Vision tests for children, before entering school, and for the elderly.

6. Hearing tests for elderly people

7. Intraocular pressure test for screening for glaucoma for people over 60, steroid users, those with a family history of glaucoma, diabetes and hypertension and those with recent eye injuries. Your eyes should be tested at:

* ages 35 and 40

* age 40 to age 60, get tested every two to four years

* after age 60, every one to two years

8. Bone densitometry in menopausal women to screen for osteoporosis. For older people with bone softness, suffering from frequent fracture, the 25 OH Vitamin D tests identify a possible deficiency in vitamin D. Vitamin D tests may also be used to help diagnose or monitor problems with parathyroid gland functioning since parathyroid hormone is essential for vitamin D activation.

9. Regular cleaning and check up of teeth for everyone every six months. Tobacco and alcohol use, diabetes, pregnancy, periodontal and gum disease, poor oral hygiene and certain medical conditions are some of the many factors that your dentist takes into consideration when deciding how often you need your dental cleaning and check up.

10. If you have a family history of diabetes, you may undergo blood tests once year to check blood sugar and insulin levels. Also test for hemoglobin A1c, or glycosylated hemoglobin. By measuring glucose bound to hemoglobin, the test gives a picture of the average amount of glucose in the blood over the last two to three months. Strict control of glucose levels through aggressive treatment and monitoring reduces the incidence of the damaging complications that can make diabetes such a debilitating disease.

People without any indicative symptoms do not need a chest X-ray, electrocardiogram or complete blood tests, since these do not provide the doctor with any clinically useful information. If you are a smoker, have high blood pressure, high serum cholesterol levels or diabetes, or are obese, or have a family history of coronary disease before age 55, you may opt for ECG.

Uma Shankari is a Bangalore-based freelance journalist. She is passionate about writing. She writes regularly on development issues, health and fitness, yoga/meditation, life and relationships. Read some her articles on http://www.helium.com/search/search?search_query=Uma

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