The information provided on the show is for general information purposes only. If you have a health problem, medical emergency, or a general health question, you should contact a physician or other qualified health care provider for consultation, diagnosis and/or treatment. Under no circumstances should you attempt self-diagnosis or treatment based on anything you have seen on the show
Some of us may dread going to the doctor’s office or put off appointments for a later date. But, it’s important to take your health into your own hands and know what and when to get checked up. A routine check up with your doctor can help catch unknown illnesses before they become serious an also ensure you’re staying in touch with your overall health.
So, what should we be asking to optimize our physical exams? Dr. Sheila Wijayasinghe shares tips on how to get the most out of your next appointment.
HOW OFTEN SHOULD YOU GET A PHYSICAL
Most people can’t remember when the last time they had a physical checkup was, even though it’s commonly believed they should happen once a year.
Dr. Sheila says there’s actual evidence of potential harm in annual check-ups for adults who don’t have any medical risk or concerns. The recommendation is to meet with your doctor to take into account your family history, medical history and medications, to evaluate how often you should be going in for a PHE.
A PHE is a periodic health exam that focuses on prevention that includes blood tests, vaccinations, screening tests for cancer and/or heart disease and risk assessment for heart disease, diabetes and stroke. These visits should happen every 2-3 years for healthy individuals. It’s important to remember that there is no one-size fits all rule, so different ages and health conditions may require more visits to the doctor.
THE DIFFERENCE BETWEEN SCREENING AND DIAGNOSTIC TESTS
Screening tests and diagnostic tests have different purposes and it’s important to know what you’re getting.
A screening test’s purpose is to detect diseases early and to prevent progression for people who don’t have symptoms. These tests help provide individuals with early treatment if they need it, which could lead to better outcomes. Diagnostic tests are looking at an existing symptom like abdominal pain or blood in stool. Some doctors will request screening tests based on your age, or you may get a reminder for a specific test in the mail or on the phone. You can also do these tests during your periodic health exam.
When it comes to monitoring our blood, there are specific screening blood tests that are recommended for everyone at some point based on your personal risk factors and age.
First, cholesterol testing depends on a person’s family history and risk factors for heart disease. If you have no risk factors, this routine screening usually starts to happen at age 40 for men and 50 for women.
You may want to do the test earlier or more often if you run a higher risk due to:
- High blood pressure
- Family history of premature heart disease
- Erectile dysfunction
- Chronic kidney disease
- Inflammatory diseases (rheumatoid, psoriasis, lupus)
Men and women over 40 should be screened for diabetes every three years. However, earlier and/or more frequent testing should be done if you’re at a higher risk due to:
- First-degree relative with DM
- History of gestational diabetes
- Ethnic background such as Aboriginal, African, Asian, Hispanic or South Asian
- Taking medications such as antipsychotics/ HAART, steroids
- Having other conditions that have a higher risk of DM associated such as Polycystic Ovary Syndrome, sleep apnea, etc…
STI’s and HIV
Periodic health reviews are an opportunity to talk about your sexual health, risks and tests with your doctor. The Public Health Agency of Canada recommends the consideration of an HIV test as a part of periodic routine medical care. Everyone who is or has been sexually active and hasn’t been tested should be offered an HIV test. The test should also be done on people who have risk factors and those who request it.
There are common vaccinations, like the flu shot, that can be taken during an annual physical for adults. Here are a couple of other vaccinations and their recommended timeline:
- Tetanus shot – every 10 years
- Pneumonia – 1 dose for those over age 65
- Flu shot – for everyone, especially if at higher risk
- Rubella – this is tested in pregnancy, but consider getting the booster shot before pregnancy, as it can’t be done during a pregnancy.
- Measles and Mumps – give 1 dose to susceptible adults born in or after 1970. If born before 1970 consider them to be immune, unless high risk.
- HPV vaccine – men and women, no age limit
- Shingles vaccine / Herpes zoster vaccine – Give 1 dose to those 60 years of age and older. For those 50-59 years of age, a dose can be considered (not covered by provincial health plans).
- Pertussis – in pregnancy between 28-35 weeks gestation
The current guidelines for pap tests suggest to start doing them at age 21, in those who have been sexually active and to continue every three years until age 70.
Pap tests screen for abnormal changes in the cells of the cervix related to HPV that can eventually lead to cancer. The majority of changes in these cells will reverse on their own time. More frequent paps would pick up abnormalities that if left alone, would return to their normal state. This is why there has been a worldwide shift in screening to be less frequent. If the abnormalities remain, they will generally be picked up by the test every 3 years.
If you have had a history of abnormal pap tests or required further review by a specialist team/surgery, you may need more frequent testing ongoing. If you have symptoms such as bleeding, you should get checked out prior to the three-year mark.
Note: there are some province to province differences in when to start screening ranging from 21-25 years of age.
For most people, mammograms should happen for people ages 50-74, every 1-2 years. Like many others, this test comes with some risk due to the radiation and studies have shown that they don’t change outcomes for early detection if done before to age 50.
If you have a family history, a genetic predisposition based on cultural background or actual symptoms – you would need a personalized risk assessment to determine how often you need it and when to begin.
Colorectal Cancer (CRC) is the second most common cancer killer in Canada in both men and women. Screening for CRC is key for early detection, prevention and better care. The tests available are:
- Stool test – a take- home test that can detect blood from polyps and can find cancer before you have symptoms
- Colonoscopy – this test is done every 10 years and requires preparation
Symptoms of depression, anxiety or any other mental health disease don’t have to be reserved for a periodic health exam. This conversation can be had with your doctor at any time.
It’s always a good idea to inform your doctor of any changes in your family history and request to be tested. Certain diseases run in families and if you’re at risk, doctors may consider screening earlier.