Assessing For Your Health

Mammography, an x-ray examination of the breast, detects early signs of breast cancer. The American Cancer Society recommends that mammography screening begin by age 40. Women ages 40 to 49 should get a mammogram every 1 to 2 years, depending on physical and mammographic findings. Women age 50 and older should get a mammogram yearly. High-risk women may be advised to have mammograms more often and at an earlier age.

Pelvic examination and Pap smears detect abnormalities of the ovaries, uterus, and cervix. The American Cancer Society recommends an annual Pap test starting at age 18 or when sexual activity begins, whichever comes first. Pap smears should not be done during the menstrual period. The test is more accurate during the first half of the cycle if oral contraceptives are taken. Midcycle is preferred in most other menstruating women. Regardless of when the test is done, the technician reading the smear must know whether you are taking oral contraceptives or estrogen-replacement therapy and when the last menstrual period began. Only with this information can the smear be accurately interpreted.

A complete eye examination includes a test for visual acuity; tonometry, a painless test for glaucoma; and cataract check. The American Academy of Ophthalmology recommends a complete eye examination from puberty to age 40 only if eye discomfort or vision problems occur. After age 40 a glaucoma test and cataract (a clouding over the lens) check should be done every 2 to 3 years.

Electrocardiograms (ECGs) are used to detect irregularities of the heart. Although there is some debate about its use as a routine screening procedure for asymptomatic (without symptoms) low-risk individuals, an ECG reading by age 35 provides a point for subsequent comparisons. Chest pain, hypertension, and symptoms of cardiovascular disease justify earlier ECGs. Stress tests use ECG to assess how the heart functions under the stress of exercise and are routine when symptoms are present.

Chest x-ray examinations are valuable diagnostic tools for people with chest symptoms, respiratory diseases, and heart problems. For people without symptoms, their routine use is questionable. Several groups of experts, including those associated with the Food and Drug Administration, recommend discontinuation of chest x-ray examinations in most cases. However, if you go to a hospital or often your doctor's office, you can anticipate a chest x-ray study more out of the need to comply with business policy than for diagnostic potential. Avoid a chest x-ray test if you may be pregnant.

Prostate cancer tests detect prostate cancer, the most common cancer among men. Men 40 years of age and older should have an annual digital rectal examination. Combined with a blood test that looks for prostate specific antigens (PSA), the digital examination significantly improves the chances of detecting early signs of cancer. The blood test for PSA should be performed annually on men age 50 and 01der.

An HIV test is recommended for people who think they may have been infected with the HIV virus. This includes people who have had unprotected sex or a blood transfusion, have used IV drugs, or have participated in high-risk behaviors. After the blood test, these people should avoid high-risk behavior for 6 months to a year and then retest.
Immunization for Adults

Many people believe that immunizations (administration of a preparation or vaccine, usually in the form of injections, for providing immunity or preventing a disease) are only for children. Consequently, many thousands of adults die every year of diseases they would not have acquired if they had received standard vaccines. For example, 20,000 people aged 65 and above die prematurely because they fail to get an annual flu shot. 24 Deaths from measles, rubella, mumps, tetanus, and diphtheria affect adults more than children-a complete reversal of 30 years ago. In addition, 40,000 people die each year from pneumococcal infections; influenza viruses kill 20,000 more. Of the 300,000 people who contract hepatitis E, 10,000 are admitted to a hospital and about 5000 die.

Adult immunization is recommended to prevent or ameliorate influenza, pneumonia, hepatitis B measles, rubella (German measles), tetanus, and diphtheria.

A chicken pox vaccine was approved in the spring of 1995. Children under can be immunized with a single injection. Adults get two shots, 4 to 6 weeks apart. The vaccine is recommended for adults who come into contact with susceptible children, such as health-care workers, day-care center employees, and elementary school teachers.