Health Screening: Finding Health Problems Early

Topic Overview

Why is it important to find health problems early?

Often, the earlier a disease is diagnosed, the more likely it is that it can be cured or successfully managed. When you treat a disease early, you may be able to prevent or delay problems from the disease. Treating the disease early may also make the disease easier to live with.

How do you find health problems early?

Your doctor may suggest:

  • Screening tests, which find health problems before symptoms appear. Examples of screening tests include mammograms to find breast cancer and colonoscopy to find colon cancer.
  • Diagnostic tests, medical examinations, and self-examinations, which find a disease or other health problem early in its course.

What health problems should you be tested for?

You and your doctor can use recommendations made by expert panels of health professionals to help you decide what screening tests you need. These panels develop screening recommendations based on:

  • Age, health, and gender.
  • Risk factors. Risk factors are things that make getting a disease more likely. They may include family history , such as having a close relative with cancer, and lifestyle habits, such as smoking. Cholesterol screening, for example, is recommended for people who have a family history of early coronary artery disease.
  • Whether or not you are pregnant. A woman who is pregnant or trying to become pregnant may be screened for genetic conditions and other conditions that may affect her or her baby.

Sometimes different expert panels make different recommendations. In these situations, talk with your doctor to decide which guidelines best meet your health needs.

How do you decide when to get a screening test?

When and how often you get screening tests may depend on your age, your gender, your health status, and your risk factors. Your doctor may suggest screening tests based on expert guidelines. In some cases, testing is done as part of a routine checkup.

When you are thinking about getting a screening test, talk with your doctor. Find out about the disease, what the test is like, and how the test may help you or hurt you. You may also want to ask what further testing and follow-up will be needed if a screening test result shows a possible problem.

Ask your doctor about the limits of the test and treatment. For example:

  • Ask your doctor how likely it is that the test would miss a disease ( false negative ), show something that looks like you have a disease when you don't ( false positive ), or find a disease that will never cause a problem.
  • Ask your doctor about the treatment for the disease. There may be no treatment that helps with symptoms or helps you live longer. In this case, you may decide that you don't want the screening test.

Also think about what you would do if a test shows that you have the disease. For example, if you are going to be tested for osteoporosis, are you willing to take medicine or make lifestyle changes if the test shows that you have it?

Screening, Birth to 12 Months

Newborn screening tests

All provinces and territories offer newborn screening, but the tests offered vary. These tests can help find serious problems that could affect your baby's long-term health. They may include:

Routine baby checkups

It's important for your baby to have regularly scheduled checkups starting shortly after birth. During these visits, the doctor examines your baby for possible problems and asks you questions about your baby's growth and development.

At each routine baby checkup, the doctor or nurse will check your baby's:

If the doctor is concerned that your child has been exposed to certain substances or diseases, tests may include:

For more information on important markers (milestones) of infant growth and development, see:

Screening, 13 Months to 12 Years

It's important for your child to continue to have regularly scheduled checkups. During these visits, your child's doctor will check your child's growth and development and examine your child for possible problems.

Routine child checkups include:

Regular dental checkups are recommended for all children.

Age-specific tests

Until your child is age 24 months, the doctor will measure the circumference of your child's head.

Until your child is age 5, the doctor will check for developmental problems, including autism . When your child is ages 10 through to 12, the doctor will check for scoliosis.

Other tests

Other tests may include:

For more information on the milestones of early childhood growth and development, see:

Screening, 13 to 18 Years

It's important for your teen to continue to have regularly scheduled checkups. At each visit the doctor will check your teen's growth and development and examine him or her for possible problems.

Routine checkups include:

  • School and Behavioural concerns, such as failing classes or dropping out of school, relationship problems with friends and family that affect home or school life, severe mood swings, lack of interest in normal activities and withdrawal from others, being physically aggressive, becoming sexually active, and using tobacco or drugs.
  • Blood pressure . Your child will likely have his or her blood pressure checked every year. After age 21, he or she can follow the adult blood pressure screening guidelines.
  • Hearing.
  • Scoliosis.
  • Vision.
  • Height, weight, and body mass index (BMI).

Dental checkups are recommended for all teens once or twice a year.

Other tests

Other tests may include:

For more information on the milestones of teen growth and development, see:

Screening, Adult Women

Screening in adults is intended to identify diseases that may develop as you age. To help stay as healthy as possible, get routine checkups and have screenings that you and your doctor decide on.

How often women have the following tests depends on age, health, and things that make a specific disease more likely.

Tests that may be done include:

Women who are pregnant or trying to become pregnant may be screened for genetic conditions , gestational diabetes, sexually transmitted infections , and other conditions. For more information, see the topic Pregnancy.

Your age and tests

Some tests are only done at certain ages.

  • Some experts recommend that all adults born from 1945 to 1975 get tested for hepatitis C. People in this age group are more likely to have hepatitis C and not know it.
  • Before age 65, screening for osteoporosis isn't generally recommended unless you have risk factors. After age 65, it is recommended you routinely have a test for osteoporosis.
  • If you are older than 65 and have a history of smoking, cerebrovascular disease, and a family history of aortic aneurysm, your doctor may recommend you be screened for aortic aneurysm.

Deciding about tests

It can be hard to decide whether you want to be screened for certain diseases or which type of test is best used. Combine medical information with your personal values to make a wise health decision.

Click here to view a Decision Point. Breast Cancer Screening: When Should I Start Having Mammograms?
Click here to view a Decision Point. HIV Testing: Should I Get Tested for Human Immunodeficiency Virus?
Click here to view a Decision Point. Osteoporosis: Should I Have a Dual-Energy X-Ray Absorptiometry (DXA) Test?
Click here to view a Decision Point. Pregnancy: Should I Have CVS (Chorionic Villus Sampling)?
Click here to view a Decision Point. STI Testing: Should I Get Tested for a Sexually Transmitted Infection?

Sometimes doctors automatically schedule routine tests because they think that's what patients expect. But sometimes research shows that testing may not be useful or worth the risks or costs. For more information, see Heart Tests: When Do You Need Them?

Screening, Adult Men

Screening in adults is intended to identify diseases that may develop as you age. To help stay as healthy as possible, get routine checkups and have screenings that you and your doctor decide on.

How often men have the following tests depends on age, health, and things that make getting a specific disease more likely.

Tests that may be done include:

Your age and tests

Some tests are only done at certain ages.

  • Some experts recommend that all adults born from 1945 to 1975 get tested for hepatitis C. People in this age group are more likely to have hepatitis C and not know it.
  • Before age 65, screening for abdominal aortic aneurysm isn't usually recommended unless you have a family history of aortic aneurysm. It is recommended that all men ages 65 to 75 be screened.
  • Before age 65, screening for osteoporosis isn't generally recommended unless you have risk factors. After age 65, it is recommended you routinely have a test for osteoporosis.

Deciding about tests

It can be hard to decide whether you want to be screened for certain diseases or which type of test is best used.

Click here to view a Decision Point. Abdominal Aortic Aneurysm: Should I Get a Screening Test?
Click here to view a Decision Point. HIV Testing: Should I Get Tested for Human Immunodeficiency Virus?
Click here to view a Decision Point. Osteoporosis: Should I Have a Dual-Energy X-Ray Absorptiometry (DXA) Test?
Click here to view a Decision Point. Prostate Cancer Screening: Should I Have a PSA Test?
Click here to view a Decision Point. STI Testing: Should I Get Tested for a Sexually Transmitted Infection?

Sometimes doctors automatically schedule routine tests because they think that's what patients expect. But sometimes research shows that testing may not be useful or worth the risks or costs. For more information, see Heart Tests: When Do You Need Them?

Other Places To Get Help

Organization

Public Health Agency of Canada (PHAC)
www.phac-aspc.gc.ca/index-eng.php

References

Other Works Consulted

  • Agency for Healthcare Research and Quality (2012). Guide to Clinical Preventive Services, 2012: Recommendations of the U.S. Preventive Services Task Force (AHRQ Publication No. 12-05154). Rockville, MD: Agency for Healthcare Research and Quality. Also available online: http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide.
  • American Academy of Pediatrics (2013). Ethical and policy issues in genetic testing and screening of children. Pediatrics, 131(3): 620–622.
  • Harrington S (2010). Screening. In CL Edelman, CL Mandle, eds., Health Promotion Throughout the Life Span, 7th ed., pp. 221–241. St. Louis: Mosby.
  • Martin GJ (2012). Screening and prevention of disease. In DL Longo et al., eds., Harrison's Principles of Internal Medicine, 18th ed., vol. 1, pp. 29–33. New York: McGraw-Hill.
  • Story M, et al., eds. (2002). Bright Futures in Practice: Nutrition, 2nd ed. Arlington, VA: National Center for Education in Maternal and Child Health.

Credits

ByHealthwise Staff

Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine

Thomas M. Bailey, MD - Family Medicine

Specialist Medical Reviewer John Pope, MD - Pediatrics

Current as ofMay 12, 2014