What tests should one get done annually/regularly after the age of 50 years? For example blood test for hemoglobin, blood sugar and kidney function, ECG, chest X-ray, PAP smear for women, bone density test, etc. Are all these really needed? Thanks for your insight.
Today's issue of New England Journal of Medicine (15th October, 2015) discusses the pros and cons of having annual screening:
Hence, there are 2 approaches:
There is no need for annual checkup, though healthy practices should be followed and early symptoms should not be ignored.
Majority of patients and physicians feel annual checkups should be there and one third of adults in USA get them done. Following simple tests can be done on an annual basis:
Annual consultation with general practitioner for history taking (asking for any symptoms or problems) and physical examination- will include blood pressure as well as checkup for skin, eye & hearing problems.
Blood tests: Hemogram (hemoglobin, total & differential white count, platelet count), sugar, kidney function (urea, creatinine, sodium, potassium), liver function (bilirubin, SGOT, SGPT, alkaline phosphatase), TSH (thyroid function), lipid profile (total, LDL and HDL cholesterol, triglyceride), vitamin D. All these tests together need only 10 ml of blood and can be done in a day on newer machines; it may be called "single syringe blood screen"! (even though vacutainers have replaced syringes for blood sampling at most places)
Urine examination: albumin, sugar & microscopic examination
- Chest X-ray every 5 years
- for women: PAP smear, mammography
Other tests to be considered:
- bone density
- prostate specific antigen is not recommended; fecal occult blood is generally indicated if any anemia is found; I am not sure what test is done for bladder cancer screening apart from urine examination mentioned above.
According to the websites bellow, it´s a good idea to do the following tests annually at age 50 and beyond (beware of false positives, which "could trigger a cascade of even more tests, only to discover in the end that you had nothing wrong with you"):
- Blood pressure if your blood pressure is borderline high.
- Skin cancer screening ("It’s important to check your own skin, preferably once a month")
- Eye exam and vision screening (every 2 years until age 60 and then yearly after that)
- Vitamin D test
- Fecal occult blood test (FOBT)
- Thyroid test
- Prostate cancer screening ("Screening should be done yearly for men whose PSA level is 2.5 ng/mL or higher, the decision should be made after getting information about the uncertainties, risks, and potential benefits of prostate cancer screening but men without symptoms of prostate cancer who do not have a 10-year life expectancy should not be offered testing" according to the American Cancer Association; but the U.S. Preventive Services Task Force "recommends against PSA-based screening")
- Testicular exam (The American Cancer Society recommends a testicular exam as part of a routine cancer-related checkup)
- For women only: Pelvic exam
- For women only: Breast exam and mammogram
If you have certain peculiarities or high risks other tests should be perform annually as well.
Information was gathered from the following websites: