End-of-Year Health Care Priorities: A Checklist
The end of the year is a good time to review your health care goals and make a plan to address any unmet care needs you may have. You can start by making a list of items to discuss with your primary care physician (PCP) and scheduling an end-of-year appointment.
Remember, your PCP is your partner in health care decision-making. Don’t be afraid to speak up and ask questions about any concerns you may have about your health.
Suggested checklist items may include:
- Annual flu shot
- Recommended vaccinations
- Medication review
- Routine physical exam
- Mental health evaluation
- Screening exams
- Diagnostic exams
Screening tests can help reveal diseases and conditions early before symptoms occur. Dr. Nancy J. Rist and Dr. Renuka Kakarala practice at Crozer Health Primary Care at Brinton Lake (formerly Internal Medicine Associates). Here are the screenings they recommend, and some suggestions of information for you to discuss with your doctor. Remember, every situation is different, so talk to your doctor about which test or tests may be right for you.
Colon Cancer Screening
A colonoscopy is a screening test that allows the doctor to look at the inside of the colon (large intestine) using a flexible tube-like instrument, or scope, equipped with a small camera on the end. This test is done to detect and remove polyps in the colon before they become cancerous. The survival rate for colorectal cancer is 90 percent when it is detected early, according to the American Cancer Society.
Although a colonoscopy is the most recommended tool for colorectal cancer screening, other options are available such as sigmoidoscopy (a variation of a colonoscopy to examine part of the colon) stool testing (used to detect blood in feces) and CT scanning. Screening is recommended beginning at age 45. For those who have a higher chance of developing colon cancer, such as a family history of cancer, screening might be done earlier. Talk to your PCP about which screening method would be best for you.
A mammogram is recommended once a year to screen for breast cancer beginning at age 40. Screening may be recommended earlier for those who have a higher chance of developing breast cancer, such as a strong family history of cancer.
A DEXA scan checks the density, or strength, of your bones to see if you are at risk for osteoporosis. According to the National Osteoporosis Foundation, 50 percent of adult females and 25 percent of adult males older than age 50 will break a bone as a result of osteoporosis. Talk to your PCP about whether you should schedule a DEXA scan.
Two screening tests are available to help detect cervical cancer early.
- Pap tests (or pap smear) look for pre-cancers (cell changes) on the cervix (lower part of the uterus, or womb) that might become cervical cancer if they are not treated.
- HPV tests look for human papillomavirus, which can cause cell changes on the cervix.
Prostate cancer screening with a prostate-specific antigen (PSA) blood test can help detect early prostate cancer. The American Cancer Society recommends talking to your PCP about the risks and benefits of screening to decide if it is right for you. This discussion should happen at age 50 for males at average risk, or younger for those at higher risk.
Lung cancer is the leading cause of cancer death in the United States — more than breast, prostate, and colon cancers combined, according to the American Cancer Society. Screening for lung cancer is recommended every year with a low-dose CT scan for people who:
- Have a history of heavy smoking,
- Smoke now or have quit within the past 15 years and
- Are between 55 and 77 years old.
Check with your insurance provider to see if your plan covers this screening. Resources may be available to help reduce the cost of screening. Talk to your provider for more information.
High cholesterol is a risk factor for heart attack and stroke. A blood test called a lipid profile can detect high levels of cholesterol in your blood. The Centers for Disease Control (CDC) recommends a lipid profile test be done:
- Once between ages nine and 11 (before puberty),
- Once between ages 17 and 21 (after puberty) and
- Every four to six years in adulthood.
Talk to your PCP about when lipid screening would be right for you.
Screening for diabetes is recommended for adults who are older than 40 and overweight, and for those who are pregnant. Other risk factors for diabetes listed by the CDC include those who:
- Have a parent or sibling with diabetes
- Are physically active (walking briskly, exercising, yard work) for 30-50 minutes less than three times a week
- Have had diabetes during pregnancy
- Are African American, Hispanic/Latino American, American Indian, or Alaska Native (Pacific Islanders and Asian Americans may also be at higher risk)
- Have non-alcoholic fatty liver disease (a condition in which fat builds up in your liver)
Talk to your PCP about your risk for developing diabetes and when screening may be right for you.
“The difference between screening tests and diagnostic tests is important to understand, said Dr. Rist. “Screenings help you and your doctors rule out health concerns that you may be at risk for. Diagnostic tests are used to figure out what you’re already dealing with. So, for example, if a screening mammogram or a breast self-exam reveals a lump, then a diagnostic mammogram, ultrasound, MRI, or biopsy will define what kind of lump you have,” she explained.
“Once you and your doctor are aware of health challenges that you need to stay on top of, talk about the timing of specific diagnostic studies,” she advised. Examples include:
- Upper gastrointestinal (GI) endoscopy for chronic heartburn
- Diagnostic breast imaging for personal or family history of breast cancer or to evaluate and perform monitoring of non-cancerous masses
- Sleep studies if you snore or have a history of apnea
- Genetic testing if you are in a high-risk group (such as having a strong family history of cancer)
“The next step is to address any diagnosed conditions with your doctor,” said Dr. Kakarala. “Many chronic conditions require testing for surveillance (monitoring). There are many possible situations when this can occur. Screening and diagnostics that can be performed before your visit may optimize your time together. Make sure that you communicate with your doctor and schedule regular visits for your chronic (long-lasting) conditions.”
Don’t forget to review your health insurance coverage and contact your insurance provider with any questions you may have about your plan.