Dr. Peter Barkett
We all want good health; there is even a toast. But how do we know what to do to ensure that good health? Some things seem obvious, like eating a healthy diet, getting quality sleep, and exercising regularly. Other times, when faced with technical information, it’s tempting to throw up your hands and say, “I just don’t know.” This is often the case with three screening tests that many patients are unaware of. But knowing them could change your life.
Often, if we can identify a health problem earlier, there is a better chance of preventing, resolving, or better managing the disease. Health screenings can detect problems even if you don’t have symptoms, so it makes sense to continue to protect your good health, especially if you have associated risks. Read on and talk to your health care provider if you think you are a candidate for these checks.
Abdominal aortic aneurysm
Have you ever filled water balloons on a hot summer day? Did you accidentally overfill any of them? If so, you have inadvertently demonstrated LaPlace’s law of physics, which states that the tension in the wall of a curved structure is proportional to the pressure multiplied by the radius. As the balloon grows, the tension in the rubber increases exponentially, until it bursts.
This phenomenon is harmless when it comes to balloons, but it is the same principle that governs the tension in our arteries. The largest artery in the body, the aorta, is particularly vulnerable. When weakened by smoking, age, and high blood pressure, the aorta can begin to stretch over time and then increase the risk of rupture. Because much of the body’s blood supply passes through the aorta, if it were to rupture, the patient bleeds so rapidly (inside) that there is very little time to intervene.
Luckily, we can both predict who is at risk for this condition and check to see if it’s already present. Ultrasound and CT scans can easily determine the diameter of the abdominal aorta and track changes over time when abnormal. We can detect these changes early enough to plan procedures that correct the bulge or aneurysm. This delay is an essential part of any good screening test.
Who is it for? The United States Preventive Services Task Force (USPSTF) recommends one-time screening for abdominal aortic aneurysm by ultrasound for men ages 65 to 75 who have ever smoked. The American College of Cardiology and the American Heart Association support a similar recommendation.
Hepatitis C virus
In a wider culture, the 1960s and 1970s are known for their clothing and music. But among health professionals, we also remember this era of the emergence of the hepatitis C virus (HCV). Before we were even aware of its existence, the virus had started circulating in the population. Now it continues to echo across health care. We have learned that HCV can persist in the body, attack the liver and cause scarring and even liver cancer.
For years, our HCV treatment options were quite limited. The drug cocktails were hard to tolerate and often didn’t work. For many patients, the best we could hope for was to monitor closely enough to detect cancers early. Then, in the 2000s, breakthroughs in research and development resulted in several new treatment options that were both much better tolerated by patients and extremely effective in eliminating HCV.
As new treatment options became available and patients outside of the baby boomer generation showed increasing rates of HCV infection, the medical community took a serious look at screening recommendations. The improved health outcomes associated with screening and testing have been enough to expand screening recommendations to routine testing; occasional for some and more frequent for people at risk.
Who is it for? The USPSTF recommends one-time screening for hepatitis C virus (HCV) for all adults ages 18 to 79 and periodic repeat screening for patients at high risk of contracting HCV.
Lung cancer screening
What do the Beatles and lung cancer screening have to do with each other? Godfrey Houndsfield, an employee of the Beatles record company, developed the computed tomography (CT) technology. It turns out that more UK taxpayers’ money may have gone into developing the project than the amount of profits from the Beatles albums, but the scanner was truly a game-changer in medicine.
For decades, medical professionals have tried to detect lung cancer at an early stage with plain X-rays. Every big study turned out to be ineffective. Then, when CT technology advanced enough and epidemiologists knew who was most at risk, the code for lung cancer screening was finally cracked.
A low-dose CT scan for lung cancer can help detect abnormal areas in the lungs early and allow treatment to begin before it has spread.
Who is it for? The USPSTF recommends annual low-dose computed tomography (LDCT) lung cancer screening for adults ages 50 to 80 who have smoked for 20 pack-years and who continue to smoke or have quit within the past 15 years .
Get tested
There’s a saying that “ignorance is bliss”, but when it comes to your health, ignorance can have real consequences. Health screenings work to detect conditions, or the first signs of them, with a good lead time to intervene with treatment that can often save lives.
For example, the USPSTF recommends colorectal cancer screening for adults ages 45-75, which saves lives every year. Many people (with no history of colon polyps or other problems) can take a simple FIT test by mail right at home. If the FIT tests detect small amounts of blood, they will need a colonoscopy, which can detect polyps or cancer at an early stage. If a polyp is discovered, it is usually removed to prevent the cancer it may have caused.
Staying mindful of your routine screenings and asking your provider for screenings that might be appropriate for your risk and age are relatively small actions that can make a big difference to your health.
Peter Barkett, MD, practices internal medicine at Kaiser Permanente Silverdale. He lives in Bremerton.
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