Preventive Health Screenings Can Save Your Life

Many people assume that if they feel fine, they don’t need to see a doctor. But according to primary care physicians, that’s exactly when preventive screenings matter most.

Dr. Amy Crawford-Faucher

“The whole reason you do screening tests is so you can continue to be healthy and feel good,” said Dr. Amy Crawford-Faucher, chair of the AHN Primary Care Institute. “Screening is what you do for people who don’t have any symptoms.”

Cancer and other serious conditions can be caught early through screening before any signs appear, potentially altering the course of your life. Cardiovascular disease ranks as the No. 1 killer of Americans, with cancer second. Screening for these conditions catches most of what kills Americans, according to Dr. Crawford-Faucher.

For cardiovascular disease, screenings include blood pressure checks, cholesterol testing and diabetes screening. For cancer, the main screenings involve mammograms for breast cancer, colonoscopies for colon cancer, Pap smears for cervical cancer and PSA tests for prostate cancer in some men.

Dr. Kim Pierce, a primary care physician with Independence Health System, emphasized that blood pressure screening is particularly critical because hypertension is a silent killer. “A lot of times people feel good but don’t know there’s an underlying risk of a disease present,” Pierce said. New guidelines from the American Heart Association recommend lower blood pressure levels around 120/80, as research has shown a decrease in dementia at these levels.

When to Start Screening

Recommended ages for various screenings have shifted as diseases appear in younger populations.

Mammograms now start at age 40, down from the previous recommendation of 45 or 50. Colon cancer screening begins at 45, down from 50, due to rising prevalence in younger people. Dr. Pierce notes that colon cancer prevention is imperative because it’s one of the few screenings that can prevent cancer by removing polyps early.

Cervical cancer screening starts at age 21. Prostate cancer screening typically begins at age 45 to 50 and continues through age 70. Lung cancer screening for smokers starts at age 50 for anyone who has smoked a pack a day for 20 years. Male smokers should also get an ultrasound of their aorta at 55 because they can develop a weakening in the aortic wall that can be fatal.

Bone density scanning typically starts at 55, though it might be done sooner for women who go into early menopause or have other risk factors.

These guidelines apply to people at average risk. Those with increased risk based on family history may need more frequent screenings.

Blood Work and What It Reveals

For healthy adults, the recommendation is cholesterol and diabetes screening every three years starting around age 40. However, doctors often check more frequently for overweight or obese patients, who typically get annual testing.

If a diabetes test comes back in the pre-diabetes range, annual retesting is recommended along with lifestyle changes. Doctors also check kidney function every one to three years for patients with high blood pressure or diabetes.

Dr. Pierce recommends that everyone have HIV and hepatitis C screening at least once. Women who are pregnant or planning pregnancy should get rubella screening. Starting in the late 40s, lipid profiles become important, and at 65, recommendations include kidney and liver function tests and anemia screening.

Essential Adult Vaccinations

Beyond childhood immunizations, adults need several vaccines as they age.

Tetanus boosters should be administered every 10 years. The current Tdap version includes protection against whooping cough. Annual flu shots help decrease flu risk and contribute to herd immunity. COVID vaccines are recommended for those with risk factors.

The shingles vaccine is vital starting at age 50. Pneumonia vaccine is now recommended as a one-time shot starting at age 50, down from 65. Those with underlying immunodeficiency or lung disorders should get it sooner.

RSV vaccine is recommended as a one-time shot for people 75 and older, though those with lung disorders should consider getting it earlier.

Measles immunity depends on birth year. Those born before 1957 are presumed immune. People born between 1966 and 1978 received the least effective vaccine and should get a booster or check immunity levels.

Breaking Down the Barriers

Despite clear benefits, several barriers prevent people from getting regular preventive care.

Access poses a significant challenge. Dr. Crawford-Faucher acknowledged a national shortage of primary care doctors and scheduling systems that don’t always make it easy for patients to come in. Dr. Pierce agreed, noting the hours of operation are a common barrier. “We’re our worst enemy encouraging people to come in and then making it difficult with time schedules,” she said.

Dr. Kate Latouf

Some healthcare systems are addressing these barriers with innovative solutions. Dr. Kate Latouf, chief medical officer at AHN Wexford Hospital, explained how their pavilion was designed specifically to improve access. “The goal of the Wexford pavilion was to build a place where we could give comprehensive and convenient access to patients. There’s same-day appointments, same-day check-ins, a true one-stop-shop for healthcare.”

The facility houses multiple imaging services including mammography, low-dose lung CT for cancer screening and MRI all on one campus. Primary care and specialty practices are on site, including cardiology, orthopedics, GI, urology and women’s health, increasing the possibility of rapid referral. The lab offers walk-in services and completes about 300 draws a day, taking just 15 minutes from start to finish.

“There is a community focus,” Dr. Latouf said. “The hospital does host educational events, screenings and health fairs to help people get some of this screening done in a means that’s hopefully convenient for them.”

Cost concerns persist even though insurance plans cover approved screening tests. Some people fear finding something wrong. “They know intellectually they should do this, but the fear of finding out they may have cancer is so strong it prevents them from having the test,” Dr. Crawford-Faucher said.

Having a strong, trusting relationship with your primary care physician is key to breaking these barriers. “If you don’t feel connected to your physician, it’s acceptable to find another one,” said Dr. Pierce.

Making the Most of Your Appointment

Dr. Crawford-Faucher loves when people bring lists of questions and concerns. For annual physicals, she recommended asking at what age you need certain tests and why.

Dr. Pierce recommended bringing your medication list, medical history and family health history. Keep good records of past health issues and diagnostic test results. “Be your own advocate and ask questions,” Dr. Pierce said. “The best outcome patients are the ones who are most aware of their health. Treat your body like it’s a $100,000 Mercedes, because you only get one.”