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March 01, 2013
PREVENTIVE HEALTHCARE FOR THE SMART ADULT
You are ultimately responsible for managing your own
health and well being. Being exposed to the stresses
and unhealthy habits of the daily urban lifestyle can
only threaten your wellness and reduce the quality of
your life.
Most of the time, it is only when one is unwell that
medical attention is sought. Malaysians in general do
not receive all the important preventive services they
need - that is, screening tests for early detection of
disease, immunizations and education about healthy
habits. Our Wellness Doctor, Dr Fariz Sazadilla
(Assunta Hospital) shares a few screening tests or
routine test for the everyday folk to get in touch with
their health and well being.
1. BLOOD PRESSURE MEASUREMENT
(to detect hypertension)
Who needs: All adults.
How often: Once every 2 years for those with normal
blood pressure.
Comments: More frequent monitoring is required for
those with readings over 140/90 and have existing
co-morbidities such as hypertension, diabetes and heart
conditions.
2. THYROID DISEASE SCREENING
Who needs: Woman 50 and over; those with high
cholesterol, family history of thyroid disease or other
risk factors.
How often: On professional advice.
Comments: If you feel you are susceptible to getting
thyroid talk to your doctor about risk factors and
getting screened.
3. CHOLESTEROL MEASUREMENT
Who needs: Men aged 35 and older (men should be
screened from age 20-35 for those with the risk of
coronary heart disease). Woman with risk of coronary
heart disease should get screened from the of 20-45 or
from 45 years old onwards if normal otherwise.
How often: Once every 5 years. More often if any
results are abnormal or you have other risk factors.
Comments: Those at high risk for heart disease
needing medical advice about lifestyle changes and
possibly drug therapy and diabetics.
4. BREAST CANCER SCREENING (MAMMOGRAPHY)
Who needs: All woman 50 to 75; those in their forties
or over 75 should discuss screening with their doctors.
How often: Every 1 to 2 years.
Comments: Certain women at high risk should also have
both MRI and mammography starting at 30. Clinical
breast exams are important to raise awareness. Consult
your doctor should you fall under the high risk
category and this includes previous history of invasive
breast cancer or benign breast disease, a "first
degree relative" with breast cancer.
5. GLAUCOMA SCREENING
Who needs: People at high risk, those over 65, very
nearsighted or diabetic; those with sleep apnea or
family history of glaucoma.
How often: On professional advice of eye specialist.
Comments: Most eye specialists advice testing all
adults 40 and over every 3 to 5 years.
6. DIABETES SCREENING
(fasting blood glucose test)
Who needs: 1. A person with diabetic symptoms such as
lethargy, weight loss, increase in urination and
thirst. 2. A person with risk factors such as, above
the age of 35 years, a BMI reading above 23kg/m2,
family history of diabetes within 1st degree relatives,
history of gestational diabetes mellitus and
hypertension among others. 3. Pregnant woman above 24
weeks of gestation.
How often: Every 2 to 3 years.
Comments: Screening can be done using random blood
glucose with a glucometer as well.
7. COLORECTAL CANCER SCREENING
(fecal occult blood test, sigmoidoscopy,
colonoscopy)
Who needs: Everyone 50 years old and over; earlier
for those at high risk. Most should stop at age 75.
How often: Fecal occult blood test annually plus
sigmoidoscopy every 5 years or colonscopy every 10
years for those at higher risks. The high risk group
includes those with a history of colorectal
polyps/cancer/irritable bowel syndrome, family history
of colorectal cancer and lifestyle factors such as
smoking, obesity, alcoholism and a sedentary lifestyle.
Comments: Those with abnormal results need more
frequent testing. X-ray with barium enema may also be
done.
8. BONE - density testing
Who needs: Woman 65 and over; younger woman at high
risk for bone loss; men above the age of 70 years.
How often: On professional advice.
Comments: Risk factors include being small-boned,
sedentary, a heavy drinker or a smoker or having a
personal or family history of osteoporosis.
9. STD TEST (sexually Transmitted Disease)
Who needs: Sexually active women 24 and younger;
older women at increased risk (such as multiple
partners).
How often: Annually or more often.
Comments: Men who have unprotected sex should also be
tested.
10. PAP SMEAR (for early detection of cervical
cancer)
Who needs: All women, starting at age 20 or when they
are sexually active. Most can stop after 65.
How often: If results are normal, every 2 years until
30, then every 3 years after 30, if a woman smokes or
has multiple sex partners or other risk factors, we
recommend HPV DNA with testing.
Comments: Women can stop at age 65 if they have had
normal result for 10 years, unless they are at high
risk. Women who have had their cervix removed do not
need to be tested.
11. PROSTATE CANCER SCREENING (prostate specific
antigen or PSA)
Who needs: Men starting at age 50.
How often: PSA on professional advice.
Comments: Discuss the pros and cons with your doctor
should you have a family history of cancer. Men should
stop screening at age 75.
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