22 April 2009PREVENTIVE MEDECINE: GENERAL HEALTH SCREENING
Growth screening
The regular weighing and measuring of children enables certain conditions to be detected early and treated. Measuring a baby’s head circumference is also a valuable screening procedure because it can alert the doctor to preventable conditions developing inside the skull.
Developmental screening
Used on babies and older children this appears to produce good results, but too little attention is usually paid to emotional and other non-physical parameters.
Blood pressure checks
Abnormal blood pressure is worth screening for from the age of 10-15 onwards. When it comes to adults, some experts recommend that every GP should use each occasion he or she sees a patient as an excuse to check the blood pressure and others claim every two years is enough.
Pap smear
This test for cancer of the cervix in women is valuable but the evidence about when it should be done is very confused. Most experts agree that the first test should be done when the woman becomes sexually active or at 20 and should then be repeated within the next year. The various cancer and health bodies around the world have different recommendations but once every five years until the age of 65 or 70 seems to be a workable suggestion. To be really sure of not missing a treatable cancer a smear should be done every year but this is considered unworkable by most people, and most women seem loath to have one done this frequently. A sensible compromise would be every other year.
Pelvic examination
The American Cancer Society recommends a pelvic examination every three years from 20-40 and then annually after 40.
The American Cancer Society recommends a breast examination every three years between 20 and 40 and then annually after 40.
Mammography
X-rays of the breast for cancer are still the best method of detecting a lump that cannot be felt but they are expensive and expose the breast to radiation. Because of these disadvantages it is sensible to have a baseline mammogram done between the ages of 35 and 50 and then annually or every other year after the age of 50.
Hearing tests
Hearing should be simply tested for at birth and then by audiology in older children. Hearing tests have been recommended every five years in adults until 65 and then every two years after that, but testing during middle life is usually a waste of time.
Vision testing
This is done as part of the pre-school examination and at regular intervals during childhood. Adult screening is recommended every five years to 65 and then every two years after that, but visual testing during the middle years is unnecessary unless the person complains of reading or visual difficulties.
Looking for squint
This is needed only for children and is done at 18 months of age and repeated several times up to the age of 6.
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