PREVENTIVE HEALTHCARE FOR THE SMART ADULT

You are ultimately responsible for managing your own health and wellbeing. Being exposed to the stresses and unhealthy habits of the daily urban lifestyle can only threaten your wellness and reduce the quality of your life.

Most of the time, it is only when one is unwell that medical attention is sought. Malaysians in general do not receive all the important preventive services they need - that is, screening tests for early detection of disease, immunizations and education about healthy habits. Our Wellness Doctor, Dr Fariz Sazadilla(Assunta Hospital) shares a few screening tests or routine test for the everyday folk to get in touch with their health and wellbeing.

1. BLOOD PRESSURE MEASUREMENT  

    (to detect hypertension)

Who needs: All adults.

How often: Once every 2 years for those with normal blood pressure.

Comments: More frequent monitoring is required for those with readings over 140/90 and have existing co-morbidities such as hypertension, diabetes and heart conditions.

2. THYROID DISEASE SCREENING

Who needs: Woman 50 and over; those with high cholesterol, family history of thyroid disease or other risk factors.

How often: On professional advice.

Comments: If you feel you are susceptible to getting thyroid talk to your doctor about risk factors and getting screened.

3. CHOLESTEROL MEASUREMENT

Who needs: Men aged 35 and older (men should be screened from age 20-35 for those with the risk of coronary heart disease). Woman with risk of coronary heart disease should get screened from the of 20-45 or from 45 years old onwards if normal otherwise.

How often: Once every 5 years. More often if any results are abnormal or you have other risk factors.

Comments: Those at high risk for heart disease needing medical advice about lifestyle changes and possibly drug therapy and diabetics.

4. BREAST CANCER SCREENING (MAMMOGRAPHY)

Who needs: All woman 50 to 75; those in their forties or over 75 should discuss screening with their doctors.

How often: Every 1 to 2 years.

Comments: Certain women at high risk should also have both MRI and mammography starting at 30. Clinical breast exams are important to raise awareness. Consult your doctor should you fall under the high risk category and this includes previous history of invasive breast cancer or benign breast disease, a "first degree relative" with breast cancer.

5. GLAUCOMA SCREENING

Who needs: People at high risk, those over 65, very nearsighted or diabetic; those with sleep apnea or family history of glaucoma.

How often: On professional advice of eye specialist.

Comments: Most eye specialists advice testing all adults 40 and over every 3 to 5 years.

6. DIABETES SCREENING 

    (fasting blood glucose test)

Who needs: 1. A person with diabetic symptoms such as lethargy, weight loss, increase in urination and thirst. 2. A person with risk factors such as, above the age of 35 years, a BMI reading above 23kg/m2, family history of diabetes within 1st degree relatives, history of gestational diabetes mellitus and hypertension among others. 3. Pregnant woman above 24 weeks of gestation.

How often: Every 2 to 3 years.

Comments: Screening can be done using random blood glucose with a glucometer as well.

7. COLORECTAL CANCER SCREENING 

    (fecal occult blood test, sigmoidoscopy, colonoscopy)

Who needs: Everyone 50 years old and over; earlier for those at high risk. Most should stop at age 75.

How often: Fecal occult blood test annually plus sigmoidoscopy every 5 years or colonscopy every 10 years for those at higher risks. The high risk group includes those with a history of colorectal polyps/cancer/irritable bowel syndrome, family history of colorectal cancer and lifestyle factors such as smoking, obesity, alcoholism and a sedentary lifestyle.

Comments: Those with abnormal results need more frequent testing. X-ray with barium enema may also be done.

8. BONE - density testing

Who needs: Woman 65 and over; younger woman at high risk for bone loss; men above the age of 70 years.

How often: On professional advice.

Comments: Risk factors include being small-boned, sedentary, a heavy drinker or a smoker or having a personal or family history of osteoporosis.

9. STD TEST (sexually Transmitted Disease)

Who needs: Sexually active women 24 and younger; older women at increased risk (such as multiple partners).

How often: Annually or more often.

Comments: Men who have unprotected sex should also be tested.

10. PAP SMEAR (for early detection of cervical cancer)

Who needs: All women, starting at age 20 or when they are sexually active. Most can stop after 65.

How often: If results are normal, every 2 years until 30, then every 3 years after 30, if a woman smokes or has multiple sex partners or other risk factors, we recommend HPV DNA with testing.

Comments: Women can stop at age 65 if they have had normal result for 10 years, unless they are at high risk. Women who have had their cervix removed do not need to be tested.

11. PROSTATE CANCER SCREENING (prostate specific antigen or PSA)

Who needs: Men starting at age 50.

How often: PSA on professional advice.

Comments: Discuss the pros and cons with your doctor should you have a family history of cancer. Men should stop screening at age 75. 

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