Screening exams are medical tests done when you’re healthy. When your doctor suggests a screening test, it does not mean he or she thinks you are sick. Screening tests are done when you have no symptoms. They can help find cancer other diseases at an early stage, before symptoms appear. When abnormal tissue or cancer is found early, it may be easier to treat or cure.
Taking charge of your own health is one of the most important things you can do for your self and your loved ones! And health screenings are the way to be your own best health advocate.
Listen in as Philip Way, MD discusses the importance of Medical Screenings as a tool for early detection of medical conditions that might require intervention.
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The Importance of Medical Screenings
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Learn more about Philip Way, MD
Philip Way, MD
Philip Way, MD specialty is family medicine.Learn more about Philip Way, MD
Transcription:
Melanie Cole (Host): Taking charge of your own health is one of the most important things you can do for yourself and your loved ones and health screenings are the best way to be your own best health advocate. My best today is Dr. Philip Way. He’s a family medicine physician at Greenville Health System. Welcome to the show, Dr. Way. Let’s talk about some general health screenings that you feel everybody should have. Let’s start with the men. What do you think are the most important health screenings men should have?
Dr. Philip Way (Guest): Well, typically, most men essentially miss specifically one of the big ones we talk about which is prostate cancer screening. There are some different opinion or different thoughts from different groups as far as if this should be done or not and how often it should be done. On average, this should be a conversation you have with your doctor at around at 45-50, depending on other health conditions. It is still recommended for some type of prostate cancer screening at 45-50, depending on your race and other health factors.
Melanie: So, you’re mentioning PSA and what about a digital? Is that at the same time? Because men are very hesitant to get this particular screening just for that reason.
Dr. Way: Yes, and I simply go over the guidelines with my male patients—what they’ve shown. Testing is that sometimes the DRE or the digital rectal exam does more harm than good. I rarely do this anymore unless patients have specific symptoms of urinary symptoms or other worrisome symptoms but I tend to use more of the PSA or the prostate screening antigen. It’s not a great test but it is a fairly decent test when done yearly to help screen for prostate cancer. We do this, typically for men who have a 10-year or more life expectancy and it has shown to be beneficial. Again, different doctor groups have different recommendations about prostate screening but it’s good to have that conversation with your doctor about what, specifically, would be the best test for you and what you feel comfortable in doing.
Melanie: So, if PSA and digital are recommended for men, what about women? What do you recommend for them and what age?
Dr. Way: Sure. Well, there are several tests that are recommended for both men and women but women, specifically, typically we want to start getting a Pap smear for cervical cancer screening at about age 21. That’s no matter when you first became sexually active. We know that cervical cancer is fairly common in females and by starting those Pap smears at age 21, you can greatly reduce your risk of developing cervical cancer. Those Pap smears used to be done annually. There are some new guidelines that say that if it’s been normal, we can go to every 3 years and even every 5 years after age 30 if they’ve been normal and we do what we call “HPV cold testing”. That’s one of the big ones that we do for females. Another big one for females is mammograms. Again, there are different recommendations on when we should start screening mammograms. Most of the guidelines recommend somewhere between age 40 and 50. Again, this is the conversation I have with my specific patient to see what their family history may be, what their comfort level is with waiting until age 50 versus starting at age 40. Once we do that and have that conversation, we get a good plan in place for breast cancer screening with a mammogram.
Melanie: And, as you said, there are some screenings for both men and women.
Dr. Way: Sure.
Melanie: Start with blood pressure. When should you be screened and checked for blood pressure problems?
Dr. Way: That’s a very good question. The basic heart screening things that we do involve blood pressure screening and cholesterol screening. Blood pressure typically is something that we check with your visit whenever you’re seen by the doctor. We typically want to get that done at least every couple of years starting at age 18. Even pediatric patients should be getting a blood pressure screen with their yearly checkup, however. We know that by just this simple screening, we can often find and treat hypertension and greatly reduce the risk of having heart attacks or other cardiovascular symptoms or cardiovascular diseases develop.
Melanie: You mentioned blood work, cholesterol. What all is in the blood work, Dr. Way? What do you want to see us get checked for? Is Vitamin D something that is involved in a regular blood work check now besides cholesterol? Glucose levels? What are you looking for?
Dr. Way: Typically, again, depending on risk factors, we often check glucose or sugar, some type of screening for diabetes. Again, this screening, there’s not a specific age range or group that is just specifically set for this but usually this is done with a yearly physical blood work. Those who are at higher risk, if they’re obese or overweight or have a strong family history of diabetes should start at a much earlier age getting that screening test done. Vitamin D is something that we very commonly see deficiencies in. It’s one of the most common nutritional deficiencies. I very rarely screen for this; however, if patients are having any specific symptoms of Vitamin D deficiency or more so if they are at risk for Vitamin D deficiency—if they’re not getting out in the sun; if they’re older and they have a lot of chronic medical problems—I’ll often check a Vitamin D level to make sure that it’s where it should be.
Melanie: And, what about body mass index? Is this something that people should be having a screening for?
Dr. Way: Well, body mass index, despite not being perfect, is fairly effective in giving physicians and patients an idea of where they are from a weight standpoint for their height. So, we consider BMI a good tool for helping us assess obesity status or overweight status or if a patient is at their normal or recommended weight. There are certain outliers where the BMI might not be quite as effective. We know that patients who have a lot of muscle mass, it might not be as effective in kind of getting a weight status for those patients. Patients who are on the shorter or taller scale for height might be a little bit more skewed towards having some BMI numbers that aren’t as accurate as they should be. It is a good screening test that we do with most visits because it can give us a very effective number, in general.
Melanie: And, one of our better cancer prevention and screening tests, the colorectal cancer colonoscopy.
Dr. Way: Yes.
Melanie: Tell us when you should have your first colonoscopy and then thereby after.
Dr. Way: Yes. For the most part, we do recommend colonoscopies in both men and women at age 50. That would be when you initially get the starting or the initial screening test done. If you have a strong family history of colon cancer, you should definitely talk to your doctor about getting one done sooner. If the colonoscopy or colon cancer screening is normal at age 50, then, typically, we say every 10 years. However, if there are some abnormal findings, if they see some polyps or some abnormal, benign cancerous masses, sometimes they want to repeat that at 3 or 5 years, depending on what they see. For the normal screening, usually they say 10 years.
Melanie: What about skin cancer? How often should someone see a dermatologist to get a full body check to look for things?
Dr. Way: Very good question. Again, there are no great guidelines and a lot of it is patient specific when we make that determination. If you have a lot of sun exposure or previous skin cancer, then we do recommend a yearly skin exam to be done. Some newer guidelines say that just screening everybody might not be the most effective pattern but, again, this is something that we’d want to talk about individually with your doctor and dermatologist about to figure out and see if you need to have that yearly skin screening done or not. I wish I could give you a better answer than that but it’s one of those that we have no good evidence supporting that everybody should get that yearly.
Melanie: So, what advice do you give every day to your patients, Dr. Way, about being their own best health advocate, getting these screenings at the recommended times and possibly keeping their own records and making sure that they understand the results the doctors give them. What do you tell people?
Dr. Way: Yes. That’s a very good question. I think the most important thing for patients to understand is the benefit of having a yearly wellness visit or a yearly physical is great. With those yearly visits, we can pretty much discuss all the health maintenance topics. We’ve just kind of hit the tip of the iceberg so far. There are so many more screening things that we talk about as far as lung cancer screenings, screening for bone density tests in women. By keeping that yearly kind of wellness visit, we can make sure that we go through all those screening recommendations that might be recommended based on their age, their sex and their risk factors. We can formulate a good plan with that visit. You are completely correct that I encourage patients to take control of their own health, to be educated on those kind of screening topics that we’ve mentioned and to focus on, in general, a healthy lifestyle with overall diet and exercise is key as well.
Melanie: Thank you so much. It’s really, really great information. Thank you, Dr. Way, for being with us today. You’re listening to Inside Health with Greenville Health System. For more information about health screenings, you can go to GHS.org/screenings. That’s GHS.org/screenings. This is Melanie Cole. Thanks so much for listening.
Melanie Cole (Host): Taking charge of your own health is one of the most important things you can do for yourself and your loved ones and health screenings are the best way to be your own best health advocate. My best today is Dr. Philip Way. He’s a family medicine physician at Greenville Health System. Welcome to the show, Dr. Way. Let’s talk about some general health screenings that you feel everybody should have. Let’s start with the men. What do you think are the most important health screenings men should have?
Dr. Philip Way (Guest): Well, typically, most men essentially miss specifically one of the big ones we talk about which is prostate cancer screening. There are some different opinion or different thoughts from different groups as far as if this should be done or not and how often it should be done. On average, this should be a conversation you have with your doctor at around at 45-50, depending on other health conditions. It is still recommended for some type of prostate cancer screening at 45-50, depending on your race and other health factors.
Melanie: So, you’re mentioning PSA and what about a digital? Is that at the same time? Because men are very hesitant to get this particular screening just for that reason.
Dr. Way: Yes, and I simply go over the guidelines with my male patients—what they’ve shown. Testing is that sometimes the DRE or the digital rectal exam does more harm than good. I rarely do this anymore unless patients have specific symptoms of urinary symptoms or other worrisome symptoms but I tend to use more of the PSA or the prostate screening antigen. It’s not a great test but it is a fairly decent test when done yearly to help screen for prostate cancer. We do this, typically for men who have a 10-year or more life expectancy and it has shown to be beneficial. Again, different doctor groups have different recommendations about prostate screening but it’s good to have that conversation with your doctor about what, specifically, would be the best test for you and what you feel comfortable in doing.
Melanie: So, if PSA and digital are recommended for men, what about women? What do you recommend for them and what age?
Dr. Way: Sure. Well, there are several tests that are recommended for both men and women but women, specifically, typically we want to start getting a Pap smear for cervical cancer screening at about age 21. That’s no matter when you first became sexually active. We know that cervical cancer is fairly common in females and by starting those Pap smears at age 21, you can greatly reduce your risk of developing cervical cancer. Those Pap smears used to be done annually. There are some new guidelines that say that if it’s been normal, we can go to every 3 years and even every 5 years after age 30 if they’ve been normal and we do what we call “HPV cold testing”. That’s one of the big ones that we do for females. Another big one for females is mammograms. Again, there are different recommendations on when we should start screening mammograms. Most of the guidelines recommend somewhere between age 40 and 50. Again, this is the conversation I have with my specific patient to see what their family history may be, what their comfort level is with waiting until age 50 versus starting at age 40. Once we do that and have that conversation, we get a good plan in place for breast cancer screening with a mammogram.
Melanie: And, as you said, there are some screenings for both men and women.
Dr. Way: Sure.
Melanie: Start with blood pressure. When should you be screened and checked for blood pressure problems?
Dr. Way: That’s a very good question. The basic heart screening things that we do involve blood pressure screening and cholesterol screening. Blood pressure typically is something that we check with your visit whenever you’re seen by the doctor. We typically want to get that done at least every couple of years starting at age 18. Even pediatric patients should be getting a blood pressure screen with their yearly checkup, however. We know that by just this simple screening, we can often find and treat hypertension and greatly reduce the risk of having heart attacks or other cardiovascular symptoms or cardiovascular diseases develop.
Melanie: You mentioned blood work, cholesterol. What all is in the blood work, Dr. Way? What do you want to see us get checked for? Is Vitamin D something that is involved in a regular blood work check now besides cholesterol? Glucose levels? What are you looking for?
Dr. Way: Typically, again, depending on risk factors, we often check glucose or sugar, some type of screening for diabetes. Again, this screening, there’s not a specific age range or group that is just specifically set for this but usually this is done with a yearly physical blood work. Those who are at higher risk, if they’re obese or overweight or have a strong family history of diabetes should start at a much earlier age getting that screening test done. Vitamin D is something that we very commonly see deficiencies in. It’s one of the most common nutritional deficiencies. I very rarely screen for this; however, if patients are having any specific symptoms of Vitamin D deficiency or more so if they are at risk for Vitamin D deficiency—if they’re not getting out in the sun; if they’re older and they have a lot of chronic medical problems—I’ll often check a Vitamin D level to make sure that it’s where it should be.
Melanie: And, what about body mass index? Is this something that people should be having a screening for?
Dr. Way: Well, body mass index, despite not being perfect, is fairly effective in giving physicians and patients an idea of where they are from a weight standpoint for their height. So, we consider BMI a good tool for helping us assess obesity status or overweight status or if a patient is at their normal or recommended weight. There are certain outliers where the BMI might not be quite as effective. We know that patients who have a lot of muscle mass, it might not be as effective in kind of getting a weight status for those patients. Patients who are on the shorter or taller scale for height might be a little bit more skewed towards having some BMI numbers that aren’t as accurate as they should be. It is a good screening test that we do with most visits because it can give us a very effective number, in general.
Melanie: And, one of our better cancer prevention and screening tests, the colorectal cancer colonoscopy.
Dr. Way: Yes.
Melanie: Tell us when you should have your first colonoscopy and then thereby after.
Dr. Way: Yes. For the most part, we do recommend colonoscopies in both men and women at age 50. That would be when you initially get the starting or the initial screening test done. If you have a strong family history of colon cancer, you should definitely talk to your doctor about getting one done sooner. If the colonoscopy or colon cancer screening is normal at age 50, then, typically, we say every 10 years. However, if there are some abnormal findings, if they see some polyps or some abnormal, benign cancerous masses, sometimes they want to repeat that at 3 or 5 years, depending on what they see. For the normal screening, usually they say 10 years.
Melanie: What about skin cancer? How often should someone see a dermatologist to get a full body check to look for things?
Dr. Way: Very good question. Again, there are no great guidelines and a lot of it is patient specific when we make that determination. If you have a lot of sun exposure or previous skin cancer, then we do recommend a yearly skin exam to be done. Some newer guidelines say that just screening everybody might not be the most effective pattern but, again, this is something that we’d want to talk about individually with your doctor and dermatologist about to figure out and see if you need to have that yearly skin screening done or not. I wish I could give you a better answer than that but it’s one of those that we have no good evidence supporting that everybody should get that yearly.
Melanie: So, what advice do you give every day to your patients, Dr. Way, about being their own best health advocate, getting these screenings at the recommended times and possibly keeping their own records and making sure that they understand the results the doctors give them. What do you tell people?
Dr. Way: Yes. That’s a very good question. I think the most important thing for patients to understand is the benefit of having a yearly wellness visit or a yearly physical is great. With those yearly visits, we can pretty much discuss all the health maintenance topics. We’ve just kind of hit the tip of the iceberg so far. There are so many more screening things that we talk about as far as lung cancer screenings, screening for bone density tests in women. By keeping that yearly kind of wellness visit, we can make sure that we go through all those screening recommendations that might be recommended based on their age, their sex and their risk factors. We can formulate a good plan with that visit. You are completely correct that I encourage patients to take control of their own health, to be educated on those kind of screening topics that we’ve mentioned and to focus on, in general, a healthy lifestyle with overall diet and exercise is key as well.
Melanie: Thank you so much. It’s really, really great information. Thank you, Dr. Way, for being with us today. You’re listening to Inside Health with Greenville Health System. For more information about health screenings, you can go to GHS.org/screenings. That’s GHS.org/screenings. This is Melanie Cole. Thanks so much for listening.
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