Maintaining one’s health is the key to living well and experiencing the best of what life has to offer. All of us would like to believe we know what’s best for us, but a regular health screening to check on our status now and then will give us the wake up call if needed or the pat on the back that we are doing the right thing. Health screenings are also necessary for those silent killer diseases which often are asymptomatic eg diabetes, hypertension and of course cancer, which often starts insidiously.
For young women in their 20s and 30s, on the threshold of fertility and at the start of their careers, a general screen for one’s basic health ie BMI, percentage body fat, and targeted screening with respect to their family history. One should ensure that they have been counselled to receive the HPV Vaccine whilst they are sexually naive and to have a papsmear once they have had their sexual debut at a minimum of three years interval and an ultrasound of the pelvis at the same time. All other vaccinations should also be screened to ensure that she has the pre-requisite immunity attained eg hepatitis B, rubella, chickenpox and measles. She should also have a basic blood screen to exclude Thalassemia or Iron Deficiency Anemia, and a urine test to exclude any significant loss of protein which might indicate a renal problem or sugar in the urine which might indicate underlying diabetes. Thyroid screening should also be performed as women tend to have a greater tendency of being hypothyroid as they avoid certain foods. Should they have had their sexual debut, contraception or fertility needs should be looked into. Sexually transmitted diseases should be screened for if they have doubts when unprotected intercourse has occurred. Self breast exams should ideally be done regularly from the 30s.
When women reach their 40s, we should be checking breast, cervix, uterine, ovarian, thyroid and cardiac status as well as bone density. These are all important areas for us to screen routinely as a lot of hormonal changes will be taking place in the 40 to 50 years interval and the incidence of breast cancer and cervical cancer have one peak in this age group and again in the 60s. It is important for women to build on their bone density at this stage. Cardiac disease should be screened by minimally performing the fasting cholesterol and triglyceride screen and measuring blood pressure on a regular basis. A faecal sample to exclude the presence of occult blood is also important to exclude any colorectal tumor.
When women reach their 50s, we should screen for various cancers, cardiac diseases and osteoporosis, which become even more critical as one progresses into the 50s. An appraisal of where one is and what one’s risk factors are will colour how often screenings should be performed. For example, for someone carrying the high risk HPV DNA , who does not as yet appear affected, she should undergo papsmear screenings every six months as opposed to a woman who does not carry the virus. Similarly for those with suspicious breast lumps or calcifications, the mammogram should be repeated every six months.
Yearly screening gives women the best outcome. However, if costs are prohibitive, then do the minimal and try to adhere to a health-sustaining diet and exercise programme. To ensure optimal health women should build good foundations whilst one is young.
|Dr Ann Tan, PBM|
|Obstetrician & Gynaecologist|
|MBBS (S'PORE), MRCOG (LONDON),|
|M MED (O&G) FAM (SINGAPORE)|