Are you up to date on your well-women screenings? Guidelines for annual screenings are developed by national health organizations to facilitate the best practices for early detection of disease. Recommendations for women are made by the American Cancer Society, the American College of OB-GYNs, and the United States Preventive Health Task Force. Check the list to see if you are getting the major screenings recommended for women.
Bone Density Screening: One in two women over the age of 50 will sustain a fracture in their lifetime. Osteoporosis is the most common bone disease and it is shameful that more women are not screened or treated if a fracture has occurred. There are more deaths from osteoporosis than breast, uterine or ovarian cancers combined!
All women 65 or over should have a DXA (an X-ray to measure bone strength). If you are over age 50 and sustained a broken bone or experienced menopause before age 45, or take certain medications (steroids in particular), or have some diseases, you are at higher risk and should be tested before age 65.
DXA results provide a “t” score. If the “t”score is lower than -2.5, you need treatment. Ask for this test if it is not ordered. Please go to the National Osteoporosis Foundation (nof.org) to learn more. This disease is seriously ignored, disabling, costly, painful and treatable.
Breast cancer screening: Evidence has not shown clinical breast exams to be effective in detecting breast cancer in women of average risk and they are not recommended for breast cancer screening. I have major resistance to this data, but that is what the research shows. Please check your own breasts anyway and share any changes such as a lump or discharge with your healthcare provider.
Mammograms: 3D Mammography is superior for breast cancer detection. No test is perfect. Sometimes there are “false positive” results that lead to a biopsy. Rarely an abnormality is missed. Ask about the accuracy and limitations of the test.
Diligently schedule mammograms! Know your family history of cancer because it helps determine the best age to begin this screening. At the next family reunion, take note of any cancers in your family tree and share this information with your healthcare provider.
Experts differ on whether to begin yearly mammograms at age 40 or 50. They do agree that women age 50 and older need a mammogram every year or every other year based on risk factors and patient preference. Aging is the biggest risk factor for breast cancer, but beyond 75 the decision to discontinue mammograms should be based on one’s overall health and a life expectancy of 10 years or more. (Who knows how long they will live??)
Pap smears: Many women are conditioned to have a “Pap” every year. This is not correct. There is a difference between a “pelvic exam” and Pap smear. A pelvic includes examination of the outer structures of the genital region for any abnormalities, as well as the vagina, cervix, uterus, ovaries and rectum.
The Pap test is done as ONE part of a pelvic exam in women who have a uterus. Cells from the lower part of the uterus (the cervix) are collected and sent to a pathologist to look for cancer cells. Even if you no longer have a uterus, a pelvic examination still needs to be done. Any bleeding after menopause should be reported immediately and requires additional testing.
The following is a summary of current recommendations for Pap smears:
♦ A Pap is NOT recommended for women younger than 21.
♦ Pap smears are recommended every THREE years in women ages 21-29.
♦ From ages 30-65, a Pap PLUS a test for the HPV virus is recommended every FIVE years. During this age span, Pap can be spaced at three-year intervals if normal.
♦ If there has been any pre-cancer or actual cancer cell detection, screening and follow-up will be more frequent. Talk with your healthcare provider about your past ♦ Pap smear results.
♦ If you’ve had a complete hysterectomy plus tube and ovary removal, a Pap smear may not be necessary after the age of 65 – unless there have been abnormal Pap smears in the past. In that case, cells may be taken from the vaginal area to make sure cancer cells have not spread to this area.
Ovarian Cancer: I have found that many women say they had a “total” hysterectomy and erroneously think everything was removed. Actually, this means only the entire uterus was removed. This is very important to know because if the ovaries are still present, they need to be checked.
There is not really a great screening test. However, if ovaries can be felt during your pelvic exam after you are menopausal, an ultrasound or other testing might be in order. Menopause is defined as the absence of menstrual periods for one year.
Colonoscopy: If you are 50, colonoscopy should be scheduled. If you have a family history of colon cancer or other risk factors, screening may need to be earlier.
Take care of yourself and schedule your screenings TODAY if they are indicated. Here’s to your health!!