A show of hands: How many of you see your doctor for a checkup every year?
Fewer men’s hands will be in the air—more than half of men 18 to 50 don’t have a regular source of health care, one-third haven’t had a physical in the last year, and 40 percent have never had their cholesterol checked. These findings are from a 2011 survey commissioned by Esquire magazine. A 2009 Centers for Disease Control and Prevention report found that men are 80 percent less likely than women to use a regular source of health care.
There are plenty of women who give doctors a wide berth, too. My mother was one of them—before she developed health problems at age 78, she hadn’t seen a doctor since she had my younger brother nearly 50 years earlier. Avoiding doctors altogether isn’t a good idea of course, but evidence on the value of regular checkups is shifting toward an emphasis on more careful screening, rather than checkups that include routine tests for healthy people.
Here are some recent guideline changes:
- The U.S. Preventive Services Task Force (USPSTF) no longer recommends the prostate-specific antigen (PSA) blood test as a routine screening for healthy men, finding that the test does not save lives overall and frequently leads to unnecessary biopsies and treatment that causes complications.
- Women are advised to have a mammogram every two years, and a Pap test every three years, rather than annually.
- There is no benefit to including an electrocardiogram in a routine physical, according to the USPSTF.
More unease about routine testing emerged when a study published in the British medical journal Lancet on June 6 raised concern about overuse of CT scans in children. The study cited observational evidence of small but significant increases in the risk of leukemia and brain cancer among children who had multiple CT scans.
In a statement in response to the study, the American College of Radiology advised parents not to refuse CT scans when used to determine head or spine injuries or complications from pneumonia. The study is likely to cast a spotlight on unnecessary use of CT scans not only in children, but in adults as well.
If you tend to avoid doctors like well, the plague, and take these findings as more reason to stay away from the doctor’s office, think again. Along with mammograms and Pap tests for women, here is a list of preventive screenings and the recommended schedule:
Body mass index to screen for obesity. This one you can check on your own at http://www.nhlbisupport.com/bmi/.
Have your cholesterol checked every five years, according to the National Heart, Lung and Blood Institute. You’ll need earlier screening (age 20 if you have risk factors such as diabetes or smoking), or more frequent testing and closer monitoring if your cholesterol is high.
Check your blood pressure every two years. High blood pressure puts you at risk of heart or kidney disease and of stroke. Many pharmacies offer blood pressure screening—see your doctor if yours is high.
If you’ve had that 50th birthday party but haven’t been screened for colon cancer, it’s time. A colonoscopy is painless, takes only 15 to 20 minutes, and the prep isn’t as bad as you might think. Colon cancer is the second leading cause of death from cancer in the U.S., after lung cancer. It’s a no-brainer to have this test to find and remove any precancerous growths before they become malignant, or to detect colon cancer early when it’s most treatable. And if your test is clear, you won’t need it again for 10 years. Despite these facts, 50 percent of Americans older than 50 have not been screened for colon cancer. If you’re in that group, make your appointment today.
If you’re healthy and have no symptoms, these screenings are sufficient to safeguard your health. And remember that no testing or doctor visit can substitute for the health protection you get from eating well, staying active, not smoking, and drinking little or no alcohol.
