All the Checkups You Need in a Year

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A new year is the time for a new start.

Make this the year that you take control of your well-being by staying up-to-date on screening tests.

In addition to your regular annual physical, here are some other things you should be screened for at certain stages of your life.

For people ages 18-39:

Cervical Cancer

The first cancer screening test ever developed was the Pap smear, used to detect cells suspicious for cervical cancer. Since women began getting regular screenings in the 1960s, cervical cancer has declined by close to 70 percent.

All women 21 and older -- or sooner if sexually active -- should have a Pap smear done every year. Recent changes in guidelines have suggested that this may not be necessary if a woman's last two Pap smears have been regular, but it's better to be safe than sorry, so you should talk to your doctor about what's best for you.

We now know cervical cancer is caused by the sexually transmitted HPV virus, and recently, an HPV vaccine has been developed. It is recommended for women under age 26, but again, talk to your doctor before you make any decisions regarding your health.

Skin Health

Melanoma, a deadly skin cancer, is the most common form of cancer in young adults age 25-29. All patients over the age of 20 should have a skin cancer-related checkup and counseling about sun exposure.

Remember your ABCDs (Asymmetry, irregular Borders, or change in Color or Diameter) when checking yourself for odd-looking moles or dark spots. Your primary care doctor or dermatologist can help you with these checkups, and many offer free skin cancer screenings in the spring.

Also, stay tuned for new smart phone apps in development that may help you and your dermatologist detect skin cancer early.

Cholesterol and Blood Pressure

Heart disease is the leading cause of death in the United States. About every 25 seconds, someone will have a heart attack, and about one person will die from a cardiovascular event every minute.

The keys to addressing heart-related health issues are prevention and early diagnosis, with a focus on cholesterol and blood pressure. According to the American Heart Association, healthy adults over 35 should have their cholesterol checked every five years and blood pressure every two years.

If you have a family history of heart disease or you are obese, your doctor should screen you sooner. Healthy diet and lifestyle early on can prevent these diseases from causing real damage to your body.

STD Screening

All sexually active men and women should be tested annually for sexually transmitted diseases such as chlamydia, gonorrhea, syphilis, human papillomavirus (HPV) and human immunodeficiency virus (HIV).

For people ages 40+:

Breast Cancer

Breast cancer affects about one in eight women and is the second leading cause of cancer death. Death rates associated with breast cancer have been on the decline since 1990 because of early detection through screening, increased awareness and advances in treatment.

Women ages 40 and over should be screened for breast cancer with yearly mammograms, or sooner if there is a family history of breast cancer. Women in their 20s and 30s will usually have a breast exam every year at their annual gynecological visit, and should be told about the benefits and limitations of doing regular self breast exams.

Colon Cancer

Adults over the age of 50 should be screened for colon cancer. A colonoscopy is invasive, but is the most effective way to detect cancer early and remove suspicious looking growths, known as polyps, from the colon.

For those who want a less-invasive screening method, speak with your doctor about stool sampling for hidden blood known as fecal occult blood testing (FOBT). Patients can do this at home and send stool cards to the laboratory. If this annual screening test is positive for blood, further testing will be required.

Prostate Cancer

The use of prostate-specific antigen (PSA) testing for early prostate cancer detection remains controversial due to the test's high number of abnormal results when cancer is not present. But the recommendations may vary by doctor.

Some doctors encourage yearly screening for men over 50, while others advise men to start testing in their early 40s if they are at increased risk for prostate cancer. But no matter where your doctor stands on this controversial topic, the general consensus is that men should be informed about the potential risks and benefits before being tested. The decision to check your PSA should be discussed with your doctor.


There are about 24 million Americans living with diabetes, but about six million of them don't realize they have the disease.

Diabetes is the 7th leading cause of death in the United States and can lead to complications such as blindness, kidney failure and lower extremity amputations.

Patients 45 and over should be screened for diabetes via fasting blood sugars, or a hemoglobin A1c test, which represents an average blood sugar level over a 3-month period.

Catching high blood sugar early may prevent a patient from developing full-blown type 2 diabetes by employing lifestyle changes like a healthier diet, increased physical activity and weight loss.

A less-publicized screen is an ultrasound for men over 65 who smoke or have ever smoked to test for an aneurysm in the abdominal aorta. Rupture of this artery is catastrophic and accounts for about 9,000 deaths per year.

Bone Health

Women over 65 should be screened every 2-5 years for osteoporosis with a bone scan. This test detects frail bones early to decrease the risk of hip and vertebral fractures.

Check with your doctor about what screening tests are appropriate for you, as these recommendations may vary based on your personal medical history.

And don't forget that vaccines are as important as screenings to keep you on track for a healthy 2011 and beyond.

Dr. Tania Mucci is a senior internal medicine resident at Mount Sinai Hospital in New York City. She graduated from Jefferson Medical College in Philadelphia and specializes in the latest advances in primary care and general health.