5 Health Screenings You Shouldn't Delay
- Skin Cancer
- Blood pressure & Cholesterol
Chances are your plans have changed because of COVID-19. Vacations and parties are getting postponed. But that doesn’t mean you should avoid seeking care, especially if you’re due for a routine health screening. Learn more about some of the most important health screenings and appointments you’ll want to keep.
Colon cancer is the third leading cause of cancer death in the U.S., leading to more than 100,000 deaths per year. A screening colonoscopy, which is a procedure designed to examine the colon for pre-cancerous polyps, can help save lives.
Andrew Bedford, MD, is a Northeast Medical Group gastroenterologist affiliated with Bridgeport Hospital. Dr. Bedford said since all colon cancers arise from pre-cancerous polyps, if you remove these polyps, you essentially remove the risk of colon cancer.
“I tell patients that by having a colonoscopy, they are vaccinating themselves against colon cancer,” Dr. Bedford said.
All men and women should get a colonoscopy by age 50 (age 45 for Black Americans.) After that, most will not need further screening for 10 years. Patients who are found to have polyps or have a higher risk for colon cancer due to a family history of colon cancer, or inflammatory bowel disease, may need to have more frequent screening exams.
Colonoscopy is performed with sedation so there is no pain during the procedure. The day prior is the preparation, which includes a clear liquid diet, like broth and ginger ale, and laxatives. Dr. Bedford explains that many patients feel like this is the hardest part of the process. But he reminds them that the investment of one day’s prep and a complete exam can provide a decade of protection against colon cancer.
“You would think that the compliance for current screening recommendations among insured patients should be 80, 90%. It’s much, much lower,” Dr. Bedford said. “So despite all of our efforts to get people to undergo this potentially life-saving preventative procedure, the acceptance rate is still too low and we see too many colon cancers for that reason.”
For those who decide not to have a colonoscopy, alternatives for screening are available that patients can discuss with their doctor.
2. Skin Cancer
Another common cancer that can be treated at an early stage is skin cancer. About one in five Americans will have skin cancer in their lifetime, with basal cell carcinoma being the most common type of skin cancer.
“When skin cancers are caught early, they’re generally not a major problem to your health. They can be treated with minor surgical procedures,” said Kathleen Cook Suozzi, MD, a Yale Medicine dermatologic surgeon. “But when skin cancers are caught at later stages, they have a higher risk associated with them.”
A dermatologist will look for signs of skin cancer during a total body skin exam. Dr. Suozzi said anyone with a family history of skin cancer should get an annual exam. Patients who have sun damage, have many moles, or take medications that alter their immune system should also get screened.
Another added benefit of a skin exam is that it can give you a baseline understanding of your skin. If you notice a mole has changed shape or color, it’s time for a dermatologist to take a closer look.
Everyone, regardless of their history with skin cancer, should protect themselves year round. Dr. Suozzi recommends wearing a mineral sunscreen with SPF 30 or higher every day, even in the winter. You will need a shot glass sized amount of sunscreen to cover your whole body. If you’re outside for a prolonged period of time, wear protective clothing and wide-brimmed hats.
A screening mammogram is a test designed to detect breast cancer early in women. During a mammogram, a patient’s breast is placed on a plate and compressed from above or the side. Then, a technologist will take mammogram pictures, which is a safe, low dose x-ray. The screening mammogram is made up of two photos of each breast and while it can be uncomfortable, it goes quickly, said Regina Hooley, MD, Interim Breast Imaging Division Chief at Yale School of Medicine.
She recommends all women 40 and older get a mammogram every one to two years. Women with a higher risk, including a strong family history of breast cancer, may need to have a mammogram every year, start screening before 40 and might also need additional screenings such as a breast MRI.
“Detecting breast cancer early can save lives. It’s been shown over many years now, since the 1980’s that getting screened regularly can decrease breast cancer mortality through early detection by up to 40%,” said Dr. Hooley.
If breast cancer is detected early, patients will also have better treatment options. While breast cancer is more common in older women, about 20% of all breast cancers are diagnosed in women in their 40’s. Overall, about one out of every eight women will be diagnosed with breast cancer throughout their lifetime.
“Black women have a higher death rate likely due to a combination of factors, but it’s important to note that all women of all races are at risk for breast cancer,” Dr. Hooley said.
Some women have dense breast tissue, which makes it more difficult to detect cancer during a routine mammogram. Dr. Hooley said those patients may then have the option of getting a screening ultrasound. But the first test all women need is still a mammogram.
4. Blood Pressure & Cholesterol
Getting a blood pressure or cholesterol screening is important to determine your future risk of cardiac disease. Often these screenings are done as part of an evaluation through the doctor’s office, but you may be able to have the screening done at health fairs through work or able to monitor their blood pressure at home. Abnormal results should prompt a visit with your doctor for further evaluation.
Daniel Price, MD, FACC, is a Yale Medicine cardiologist and the Ambulatory Medical Director for the Yale New Haven Hospital Heart and Vascular Center. Guidelines suggest all adults should have a baseline reading in early adulthood. He recommends a repeat blood pressure screening every two years for all adults with a normal blood pressure reading of less than 120/80 mmHg. Some patients may need to be screened yearly, including adults with elevated levels that are higher than normal but don’t meet the criteria for hypertension, patients who are overweight, or patients over 40.
He emphasizes that younger patients, especially men in their 20’s and 30’s, still need to get their blood pressure checked. That’s because Dr. Price said many people with high blood pressure don’t have symptoms. Unrecognized, uncontrolled high blood pressure can lead to strokes, heart attacks, and kidney failure.
“If you pick up someone who has significantly high blood pressure, we have medications and recommendations for lifestyle modification that will improve your blood pressure and reduce your risk,” Dr. Price said.
Elevated cholesterol levels can also leave patients at risk for heart attack and stroke. Patients should get checked every four to six years once they reach adulthood. A normal reading should have a total cholesterol level of less than 180 mg/dL and LDL less than 100 mg/dL.
In a screening, you’ll want to pay attention to the three components of cholesterol: LDL, HDL and triglycerides. HDL is what’s considered to be the “good” cholesterol, while LDL is considered to be the “bad” cholesterol. As you age, your cholesterol levels can change. If that’s the case, Dr. Price said you may not need medication right away. Sometimes, a change in lifestyle is all it takes.
Many health screenings are recommended for patients later in life. But parents can help protect their child’s health now by making sure they stay up to date with their vaccinations.
Within the first four years of life, children need a host of vaccinations to prevent potentially devastating diseases. Some of the common vaccinations are for diphtheria, whooping cough, polio, tetanus, measles, mumps and rubella. Any booster shots are important too, designed specifically to drive lifelong immunity.
Gregory Germain, MD, Associate Chair, Department of Pediatrics at Yale New Haven Children’s Hospital, said any gap or delay in vaccines can leave children open to risk. That’s why it’s so important for parents to stay up to date on their child’s vaccinations, even though schools and other activities may be closed due to COVID-19.
“Every time you leave your house and break quarantine, you’re taking a risk,” Dr. Germain said. “I would put your child’s pediatric visit right up there with a high value, low risk departure from quarantine. It may be one of the most important reasons that you leave your house.”
For parents nervous about bringing their child in to the doctor’s office, Dr. Germain said they’re following strict CDC guidelines to protect families. All of the providers, patients and parents must wear a mask. They’re not using waiting rooms to ensure social distancing, parents won’t have to touch any clip boards or sign-in sheets and rooms are sanitized after every patient.
“Walking in to your pediatrician’s office, you might not recognize it, even though you’ve been there many times before,” Dr. Germain said.
Whether you’re going to your doctor’s office for a skin exam or a procedure like a colonoscopy, your experience will look different. Everyone will be wearing a mask, the check-in desk may have a plexiglass barrier and you’ll need a temperature check as soon as you arrive. All of those measures, along with increased sanitizing, is designed to keep both the patient and provider safe. If you need to stay home, your doctor may be able to offer services through Telehealth video conferencing. Learn more about Yale New Haven Health’s focus on safety: