All of us want to live a longer life without the fear of degenerative disease or physical disability. HEALTH discovers that a longer and healthier life span is actually possible with the advent of new laboratory screenings devised to provide an internal snapshot of our body helping to empower us to take proactive steps towards a healthier lifestyle.
Reasons for Testing
When Naveed Khan, an IT expert in Dubai had his routine medical check-up 10 years back, he never imagined that he would be diagnosed with pre-diabetes. “While I was feeling a bit tired I simply chalked it down to over-working. Also I had no time to exercise and was eating heavy meals late at night. Yet because I managed to get tested in advance, I learned that I was not only suffering from pre-diabetes but also in the very early stages of hypertension related to my cholesterol levels. With the advice of my doctor and a nutritionist, today I am managing both of the problems with lifestyle modification which includes daily exercise, healthy meals and medications,” he says.
Not alone, many of us look and feel relatively healthy but have no idea of what’s happening internally; a fact that makes preventive testing so vitally important. And from cancer to diabetes, Dr.Palat Krishna Menon, Director of Laboratory Services at GMC Hospital and Research Center in Ajman explains that once a person has been diagnosed with a disease, many irrevocable changes could have happened in the body which are difficult to reverse. “This, then, increases the person’s requirement for medication, hospitalization and can compromise the overall state of health,” he says. “However the good news is that despite the increase in degenerative diseases, with today’s advances in the field of diagnostic medicine, it actually is possible to detect diseases much before they have manifested and as a result, the individual that has been diagnosed can make the required lifestyle changes to live a healthy and normal lifestyle.” Furthermore, Dr. Sanjida Ahmed, Director of Research and Development at Eastern Biotech & Life Sciences in Dubai adds that preventing disease and detecting disease early, if it occurs, are important keys to living a healthy life.
When To Begin
In today’s modern times, Dr. Menon points out that the rate of obesity is on the rise. “While children do not get adequate physical activity, adults are also under tremendous stress as they do not exercise enough and do not relax enough being busy all the time,” he says, and these increasedstress levels actually predispose them to many lifestyle disorders including hypertension, cardiac disease, diabetes, skin disorders and endocrine disorders. “Therefore it is advisable that an individual should ideally undergo preventive screening testing at least once a year after the age of 20,” he explains, with the first step being a simple height and weight measurement to calculate the Basic Metabolic Index or BMI. He advises that any individual with an enhanced BMI should consider active screening of his/her health status.
As one grows older, Dr. Menon urges that it is important that initially until age 30, testing is done every alternate year for basic profiles such as liver profile, kidney profile, diabetic profile and cardiovascular profile along with blood pressure, height and weight check. And with age, these tests have to be repeated annually and results reviewed by an appropriate medical doctor in order that changes can be detected early. Dr. Ahmed adds that people having strong family history of any genetic conditions should take the precautionary measures earlier than that. “If one’s family has a higher risk for certain health problems, such as heart disease, stroke, and cancer, they need to screen as early as possible to know the risk of developing such conditions in the future,” she says.
The Next Step
Dr. Menon tells that recently the BRACA A gene test has been in the news especially after Angelina Jolie announced to the public that she had undergone a bilateral mastectomy followed by bilateral breast implants following BRACA A gene detection. Dr. Menon adds that what is perhaps even more important is regular follow up – probably at an increased frequency so that any early cancer can be detected and can be removed as soon as possible. Basically a positive result to this test, tells Dr. Ahmed, gives valuable information that can be used to: reduce the risk, take proactive steps and make informed choices. Managing risks, she continues, means increased surveillance via a monthly breast self-exam beginning between the ages of 18 and 21 and annual or semi-annual clinical breast exams, beginning between the ages of 25 and 35. “Also yearly mammography and breast MRI beginning between the ages of 25 and 35 as well as an annual or semi-annual trans-vaginal ultrasound to screen for ovarian cancer beginning between the ages of 25 and 35,” she notes.
Dr. Menon firmly stresses that preventive screening tests play an important role in helping a person make adequate lifestyle changes. He cites the following example, “More and more younger people are suffering from Coronary Artery disease (CAD) which occurs when lipids begin to get deposited on the vessel valve of the heart. For this problem, a simple lipid profile is the first step of a test which can be used to prevent coronary artery disease.” However, nowadays newer tests are available, for example, he says that in the lipid profile, the LDL is supposed to be the dangerous fraction which is responsible for Atherosclerosis, however, what is not well publicized is the fact that LDL has two sub-fractions – the heavier fraction and the lighter fraction. “It is the smaller fraction of LDL that is responsible for coronary artery disease and it is important to sub-classify the LDL fractions so that one can actually correlate it with cardiac risks,” he explains, therefore even if a person has a normal lipid profile, he strongly suggests an individual undergo a lipid profiling so that the LDL sub-fractions are delineated. “Then we are able to design intervention strategies to change the LDL sub-profiles to normal,” he says.
And besides diabetes, chronic kidney disease is yet another disease that can be tested for in advance. “In chronic kidney disease, the kidney starts showing signs of kidney failure much before it manifests,” he says. “The test– micro albumin—is usually done along with urinary creatinine which detects early kidney disease and can be used to treat it early before the disease becomes Frank Nephrotic Syndrome.”
Women’s Top Tests (Under age 50)
In the case of women, Dr. Menon suggests that the first and most important test they should undergo on a periodic basis is a mammogram.
Pelvic Exam and Pap Screen
Next, Dr. Menon urges that women should undergo a cervical cytology with HPV (Human Papillomavirus testing) as breast cancer and cervical cancer are the causes of death in women. Dr. Ahmed adds that Pap screen testing should begin at age 21 while routine screening is recommended every three years for women between ages 21 to 65 years old. “However for women between ages 30 to 65 years who have a normal Pap test with a negative HPV test, screening can be done every five years,” she says.
Diabetes and the Heart
According to the American Diabetes Association, all patients should be screened for diabetes at three-year intervals beginning at age 45, especially people who are overweight or obese. Also once a woman ceases her menstruation cycle, Dr. Menon explains that she is at an increased cardiac risk and that is where the testing for diabetes and cardiac disease comes in.
It’s simple, it’s cheap and it’s quick, explains Dr. Ahmed. “Women don’t always have to go to the doctor’s office to have blood pressure checked; it can be monitored at home,” she says and this is especially important if one has a strong family history of blood pressure.
Everyone age 20 and over should know their cholesterol numbers, and get them checked at least once every five years, urges Dr. Ahmed.
Tests For Pregnant Women
In the case of a pregnant woman, Dr. Menon recommends that the most important test is a regular antenatal check. “It is also advisable to do a maternal serum screening especially in the first trimester of the pregnancy, so that she can understand the possibility of having a baby with an unusual number of chromosomes potentially resulting in a baby with Down’s syndrome or Turner’s syndrome,” he says.
These are genetic tests which Dr. Ahmed explains need to be done only once in a life time. “Once the risk is known, management of the conditions is required to prevent the conditions,” she says and there are various types of screenings available which are important at different stages of life.
Risk Assessment Screening options:
Pre-marital Screening: Before getting married, an individual should know the genetic compatibility between the couple.
Prenatal Screening: To know if the fetus is affected with any chromosomal abnormalities, first trimester, second trimester screening and non-invasive or invasive prenatal diagnosis are recommended.
Newborn Screening: 24 hours after the birth of a child, the screening is done to ascertain the metabolic/genetic and endocrinological disorders.
Carrier Screening: To know the carrier status of an individual if any genetic condition exists in the family.
Cancer Genetic Screening: To know the risk of hereditary breast, ovarian, and colon cancer.
Risk assessment test: To evaluate the risk of developing certain conditions in the future, such as hypertension, diabetes, or heart conditions.
Sexually Transmitted Disease (STD) Screening: To screen for a panel of STDs that include Chlamydia and Gonorrhoea in addition to Cytology and HPV genotyping can reduce the risk of cervical cancer.
Top tests for women over 50:
Breast Cancer Screening
Your health care professional should examine your breasts for any abnormalities once a year. This exam often is part of the annual gynaecologic examination. One should be screened for breast cancer with mammography every year.
Cervical Cancer Screening
Women over 50 need to get a Pap test every three years or both a Pap test and an HPV test every five years. The Pap test screens for abnormalities that could indicate pre- or early cervical cancer. If someone has risk factors such as previous abnormal screening results or HIV infection, she should undergo a Pap test every year.
Colorectal Cancer Screening
Women 50 years and older should be screened for colorectal cancer using any of several screening methods. There are a number of tests that screen for colorectal cancer, and they are divided into two groups: tests that find both colorectal cancer and polyps, and those that mainly find cancer.
Osteoporosis Screening (Bone Mineral Density Test)
Osteoporosis is a condition that causes bones to become brittle and fragile. It’s most common in women over 50, and symptoms include a tendency to fracture easily. If a woman shows signs of early osteoporosis, a DEXA bone scan can help determine whether she has the condition or are at risk of developing it
Everyone age 20 and over should know their cholesterol numbers, and get them checked at least once every five years.
Blood Pressure & Hypertension
Women over 50 should check blood pressure at least once a year if normal; more often if it is at or above 120/80.
Diabetes should be screened every year; more often or earlier if you’re overweight or have other risks for diabetes.
Top tests for men:
Even if someone feels fine, it is still important to see the health care provider regularly to check for potential problems. Most people who have high blood pressure don’t even know it. The only way to find out is to have blood pressure checked regularly. Likewise, high blood sugar and high cholesterol levels often do not produce any symptoms until the disease becomes advanced.
Age-specific guidelines are as follows:
Blood pressure screening
One has to check blood pressure every two years unless it is 120-139/80-89 Hg or higher. Then it should be checked annually. After the age of 50, it is advisable to monitor blood pressure once a year.
Cholesterol screening and heart disease prevention
Men over age 34 should be checked every 5 years. If one has diabetes, heart disease, kidney problems, or certain other conditions, he may need to be monitored more closely.
Colon cancer screening:
People between ages 50 and 75 should be screened for colorectal cancer. This may involve:
• A stool test done every year.
• Flexible sigmoidoscopy every 5 years along with a stool occult blood test.
• Colonoscopy every 10 years.
• People with risk factors for colon cancer, such as ulcerative colitis, a personal/family history of colorectal cancer, or a history of large colorectal adenomas may need a colonoscopy more often.
Preventive health visit every 2 years until age 50, and then once a year, should include:
• Checking height and weight
• Screening for alcohol and tobacco use
Prostate cancer screening:
Most men age 50 or older should discuss screening for prostate cancer with their health care provider. A PSA blood test is usually recommended to screen for prostate cancer.
All men should be monitor glucose levels yearly after the age of 50.