A number of screening tests have been developed that have made significant improvements in the lives of many individuals worldwide. While good screening tests are not 100% accurate in all cases, it is generally more valuable to have the screening tests at the appropriate times, as recommended by your healthcare provider, than to not have them at all.
What is a screening test?
A screening test is done to detect potential health disorders or diseases in people who do not have any symptoms of disease. The goal is early detection, and lifestyle changes or surveillance, to reduce the risk of disease, or to detect a disease early enough to treat it most effectively. Screening tests are not considered diagnostic, but are used to identify individuals who should have additional testing to determine the presence or absence of disease. One of the most common screening tests is the Pap smear or Pap test.
Which tests are right for you?
Getting your blood drawn to measure the good and bad cholesterol, having a blood pressure cuff wrapped around your arm to check for hypertension – these are examples of medical screening tests that have become a familiar part of a routine medical checkup or physical examination. Some screening tests are not required by everyone. Which screening tests to do, and at what age they should be performed, are issues for debate in many countries, including Anguilla. It is for this reason that individuals are encouraged to talk with their experienced and knowledgeable doctor so that together a decision is made on the merits of any screening test. Be sure to consult your healthcare provider regarding the appropriate timing and frequency of all screening tests based on your age, overall health, and medical history.
Characteristics of a good screening test
There are a number of screening tests available, but not all of them are appropriate for use by the general public. A good screening test in health must have the following:
• be inexpensive
• be easy to administer
• cause minimal discomfort
• be reliable (consistent)
• be valid (distinguishes diseased & non-diseased people)
There is much debate concerning a number of screening tests. Always discuss with your doctor before doing any screening test.
Common screening tests
A number of screening tests are available on Anguilla. The following are some common screening tests that many individuals are encouraged to have:
Pap test (also called Pap smears)
Pap smears are samples of cells taken from the cervix in women to look for cellular changes indicative of cervical cancer. The Pap smear is an important screening test in sexually active women, under the age of 65, to detect cancer at a stage when there are often no symptoms. It is important to understand that a Pap smear may be referred to as “abnormal,” but may not mean that a person has cervical cancer. Some organizations also recommend HPV (human papilloma virus) screening in certain populations during the Pap smear.
Prostate specific antigen (PSA)
This blood test measures the prostate specific antigen (PSA) levels in the blood. Antigens are any substances that evoke responses from a person’s immune system. The prostate specific antigen levels can be elevated in the presence of prostate cancer. However, it is important to understand that other benign prostate conditions may also elevate PSA – such as benign prostatic hyperplasia (BPH) which is noncancerous swelling of the prostate. The PSA test is not recommended for all men, and there is considerable controversy over the role of PSA testing. The pros and cons of PSA screening should always be discussed with your healthcare provider before testing. Some of the cons include unnecessary testing and procedures, unnecessary costs, and significantly increased anxiety.
Screening for high blood pressure
Many doctors recommend hypertension screening for adults 18 and older using the standard blood pressure test. Blood pressure should be taken by a trained healthcare professional. Most doctors recommend yearly checking of blood pressure for asymptomatic individuals – and more frequently for individuals with risk factors such as a family history of hypertension.
Cholesterol measurements
Cholesterol screening is performed by a blood test. People with high cholesterol measurements from a blood sample have a higher risk for cardiovascular disease (CVD) than those with cholesterol in the normal range. Studies have shown that people with high cholesterol can reduce their risk for heart disease by lowering their cholesterol. It is important to understand, however, that people can still have heart disease even with cholesterol levels in the normal range.
Mammography
Many clinicians and groups recommend mammography screening for breast cancer every 1 year to 2 years after age 50. You should always discuss with your doctor when and how often to have a mammogram. This test is done in conjunction with a clinical breast exam. There can be false positive results from a mammogram test. If you have concerns always discuss your concerns with your doctor.
Colonoscopy
Many doctors recommend screening for colon cancer or colon polyps at age 50, and earlier if you have a family history or other risk factors. A person at average risk is advised to get a colonoscopy every 10 years up to the age of 75 years.
Diabetes or prediabetes
Many doctors recommend that all adults be screened for diabetes or prediabetes starting at age 45, regardless of weight. Additionally, individuals without symptoms of diabetes should be screened if they are overweight or obese – and have one or more additional diabetes risk factors.
Conclusion
Screening tests are used to determine whether an asymptomatic individual has an undetected disease or condition. A number of screening tests are now available. Unfortunately some screening tests lack credible scientific bases and misrepresent the risks and benefits of testing to the patient. Many of the tests are marketed directly to the patient, so it is important for people to know what makes a screening test “good.” Individuals are encouraged to have regular medical check-ups and discuss with their doctor which screening test they should have and the frequency of these tests.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-six years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
Consult your healthcare provider regarding all of these as well as other types of screening tests, based on your medical condition, as not all healthcare providers are in agreement in regard to which screening tests should be done and for which age groups.
