When it comes to women's health, there are five health tests that have saved lives and helped improve the quality of life for millions of women, and yet are still underutilized, ignored or forgotten about.
My patients are so busy that it's understandably difficult to put health on their never-ending and infinitely-expanding to-do lists. Many of us are so busy caring for everyone else in our lives that we are often at the bottom of the list, or worse, not on it at all.
To live a long and healthy life, this is my list of the five health tests that women can't ignore.
1. Pap Smear
Most of us equate a Pap smear with having a pelvic exam, and it's also the best way to detect precancerous and cancer cells of the cervix. Before Dr. George Papanicolaou developed this test in the 1950s, cervical cancer was one of the leading causes of death for women in the U.S.
Though the number of women diagnosed with cervical cancer in the U.S. has declined by more than 60 percent, there are still more than 12,000 women diagnosed and more than 4,000 women who die from this treatable form of cancer each year. Worldwide, the number is more than 20 times higher. The key to early detection, diagnosis and treatment is having regular Pap smears.
When should women start getting Pap smears? The current guidelines from the Center for Disease Control and Prevention (CDC) recommend that the first Pap smear be done at age 21 and regularly after that until age 65, or until women have had years of normal Pap smears and no other risk factors. For women who are more than 30 years old, it's also recommended that they be offered screening for the human papilloma virus (HPV).
Pap smears aren't painful and take less than one minute in a health care provider office. We obtain cells from the cervix, which are then examined for the presence of any precancerous or cancer cells. Results are available within two weeks.
If you've been putting off having a Pap smear, make your appointment today. It could save your life.
2. Trigylcerides and Cholesterol
You've probably heard that you should have your cholesterol levels checked, and now we know that triglyceride levels are just as important. Total cholesterol (and LDL cholesterol levels in particular) alert us to the likelihood of early buildup of fatty deposits known as atherosclerotic plaque in the blood vessels. As cholesterol levels increase, the risk of heart attack also increases.
This is a great video from the American Heart Association on how cholesterol causes heart disease.
- Total Cholesterol < 200
- LDL Cholesterol < 100
- Triglycerides < 100
- HDL Cholesterol > 45
Why it's important: Knowing triglyceride levels help us predict and determine the risk of two diseases: diabetes and heart disease. High trigylcerides (above 150) may indicate an underlying insulin resistance that can ultimately lead to Type 2 diabetes and heart disease.
Triglycerides are formed as a byproduct of carbohydrate metabolism and are one of the building blocks for LDL cholesterol. Having a high carbohydrate intake plus insulin resistance can lead to high triglyceride and LDL cholesterol levels.
When to start testing: Though guidelines differ, the American Heart Association endorses the National Cholesterol Education Program (NCEP) guidelines for detection of high cholesterol. Most women can start testing in their 20s, and if they're in a normal range, be retested every five years. For those who have higher values -- diet, exercise and medication may mean that they need more frequent follow ups. Cholesterol and triglycerides are easily tested with a simple blood test that's given early in the morning after at least 10 hours of fasting.
3. Prenatal Genetic Testing
In the last year, everything has changed when it comes to testing in pregnancy for genetic conditions. Now with new genetic testing techniques, we can offer highly-accurate genetic testing that doesn't involve any risk, with a simple blood test starting at 10 weeks of pregnancy. Known as non-invasive prenatal testing, NIPT offers pregnant women significant improvements over what we could offer them in the past.
In the past, we offered women a long list of ultrasounds, blood tests, amniocentesis and chorionic villus sampling (CVS) to determine both the sex of the baby and whether the most common genetic conditions were present. These tests, while the best we had at the time, also carried with them high false positive rates of five percent or more, meaning many women were asked to undergo invasive testing with amniocentesis or CVS, which both carry a risk of miscarriage.
Now, we can use the woman's blood to look for the baby's DNA and determine with more than 99-percent accuracy the presence of the most common genetic conditions. This new, non-invasive test helps eliminate unnecessary amniocentesis and CVS, because the false-positive rates are less than 1 percent. This has helped decrease the number of miscarriages from those invasive tests. The tests can also determine the sex of the baby and can be done on identical twin pregnancies.
4. Mammograms
Many of my patients are confused about the contradictory guidelines that seem to be announced every few months that tell women not to have regular mammograms. And yet, at the same time, most of us know women who've been diagnosed in their 40s and whose lives were saved because they were having mammograms every year.
Here's what the American Cancer Society recommends and what I follow with my patients. Start mammograms at age 40 and have them every year until your mid 80s. If you have a family history of breast cancer, talk to your health care provider about BRCA testing.
Mammograms have changed a lot in the last few years. They are more comfortable, and most breast-health centers use digital mammography, with some using 3D mammography to help eliminate false-positive results and see smaller breast cancers. Women with dense breast tissue may need additional screening with a breast ultrasound using an Automated Breast Ultrasound System, (ABUS) recently approved by the U.S. Food and Drug Administration.
5. Colonoscopy
Most people are surprised to learn that colorectal cancer is the third-most-common type of cancer diagnosed in both men and women, and yet, with early testing, detection and treatment, five-year survival rates are more than 90 percent!
I get it. Having the prep and then going in for a colonoscopy is not high on people's lists of fun things to do, however, the effort and time is well worth the peace of mind and the opportunity to detect precancerous cells and remove them early. Yes, I wish that vodka and tequila were the types of clear liquids we could have during the colonoscopy prep, but that hasn't been developed yet. In the meantime talk to your health care provider about newer "quick preps" and get scheduled.
When to have a colonoscopy: For people without a family history, it's recommended to have the first colonoscopy at age 50 and then every five years after that. If there's any family history of colorectal cancer, it's recommended that the first colonoscopy be done five years earlier than the age the youngest relative developed colon cancer.
Yes, having a colonoscopy is a real pain in the you-know-what (literally), but it could save your life (literally).
There are more tests that women may want to have, including a vitamin D level test, a C-Reactive protein levels test, a bone mineral density test and fasting glucose levels test. To learn more visit NurseBarb.com.
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