Thanks to the Affordable Care Act (ACA), many preventive tests are now available for free. But with such a comprehensive list of screening options, it is hard to know where to begin. Start small with these six screenings.
1. Blood pressure
Nearly one in three Americans has high blood pressure, also known as hypertension. It's a medical condition with few symptoms -- but a key indicator of other health concerns. Blood pressure should be tested every two years after age 18, and more often once you reach 40 -- and the ACA makes this screening free to all. Blood pressure is reported as two numbers. The first is the pressure in the arteries as the heart beats; the second is the measure of pressure in the arteries when the heart rests between each beat. Normal blood pressure is below 120/80 ("120 over 80"), and high blood pressure is classified as anything above 140/90.
High blood pressure puts you at risk for overstretching and injuring your artery walls, and it increases your risk of heart attack, stroke, heart failure, kidney failure and tissue and organ damage.
If you are diagnosed with high blood pressure, follow your doctor's instructions regarding lifestyle changes and medication. There are several things you can do to be proactive in lowering it, including eating healthy foods, staying active with 2.5 hours of aerobic exercise each week and losing weight through healthy lifestyle changes. Women who are pregnant or considering getting pregnant should be especially wary of high blood pressure -- this and other issues can be addressed at a well-woman visit, which is also free under the ACA.
2. Type 2 diabetes
If you have high blood pressure, you should have also have a free Type 2 diabetes screening performed. Type 2 diabetes is the most common form of diabetes and often occurs in overweight people. Diabetes occurs when the blood sugar levels are too high, which can lead to nerve damage, kidney disease, blindness and other disabilities. Symptoms of Type 2 diabetes include excessive thirst or hunger, fatigue, blurred vision and cuts/bruises that are slow to heal. Lowering blood pressure, weight and cholesterol can help to control and manage type II diabetes.
3. Depression
Major depressive disorder affects 14.8 million American adults, or 6.7 percent of the adult population in the U.S., and is the leading cause of disability in the United States for people between the ages of 15 and 44. The lifetime risk for depression is about 17 percent, and women are more susceptible. Depression often occurs for more than two weeks at a time and can include feelings of hopelessness, guilt, or shame, too much or too little sleep, loss of interest in previously enjoyed activities, and thoughts of suicide or death.
This potentially debilitating disease can interfere with the ability to study, work, eat, sleep, or fulfill responsibilities. During a free screening for depression, doctors can check for major depression, dysthymia (a more chronic form of depression) and bipolar disorder, as well as other anxiety disorders that can frequently occur at the same time. Depression can be treated with cognitive behavioral therapy, antidepressants or both.
4. Cervical cancer
Cervical cancer is the second leading cause of cancer in the world. Each year in the United States, 12,000 women are diagnosed with cervical cancer, and more than 4,000 women die. Cervical cancer is one of the most preventable types of cancers, if detected early through a Pap smear -- a short test that typically includes a pelvic examination and a sweep of the cervix with a special brush to collect a sample of cells. If abnormalities are detected in the cells, follow-up care can halt the progression of cancer and ultimately be life saving.
Human papillomavirus (HPV) is a major cause of cervical cancer, found in 99 percent of cervical cancers among women, and it can be screened for during the same doctors visit. Approximately 79 million people are estimated to currently be infected with HPV, with an estimated 14 million new cases each year. HPV can often be prevented with a vaccination, which the ACA covers. For women in their 20s, a Pap smear is recommended every three years, and for women aged 30-65, a Pap smear and HPV screening are recommended every five years. HPV symptoms often go unnoticed for years, and cervical cancer can take 10 to 20 years to fully develop, so even women who are no longer sexually active should get screened.
5. Cholesterol
If you are one in six Americans who has high cholesterol, you are at risk for heart disease, heart attack and stroke. Too much cholesterol -- a waxy, naturally occurring substance in the body -- can build up in the arteries and restrict blood flow. When combined with other risk factors, such as high blood pressure or diabetes, high cholesterol becomes even more dangerous. Cholesterol screening is usually performed by measuring the lipid profile through a fasting blood test, which requires you to fast for 9 to 12 hours prior to the test. The lipid profile measures total cholesterol, HDL (good) cholesterol, LDL (bad) cholesterol and triglycerides. Ideally, you want a total cholesterol level less than 200, an HDL score of more than 60, an LDL cholesterol score less than 130, and triglycerides less than 150. If cholesterol screening indicates high cholesterol, your doctor might recommend medicine or lifestyle changes such as eating food with less fat and cholesterol, exercising more and avoiding tobacco smoke. Screening for cholesterol is recommended every five years for men over age 35, as well as men under age 35, and women who have, or are at risk for, heart disease.
6. HIV
The human immunodeficiency virus (HIV) can develop into acquired immunodeficiency syndrome (AIDS). No cure for HIV currently exists. If it is caught in early stages, however, HIV can be controlled through the use of antiretroviral therapy (ART), which can help one to live a relatively normal life. HIV is contracted by coming into contact with the bodily fluids of someone with the virus -- this can be through unprotected sex, sharing of needles, breastfeeding or a blood transfusion. The only way to know if you have HIV is to get tested; therefore, everyone aged 15-65 should get tested at least once. Pregnant women should also get tested, as the virus can be spread from baby to mom during delivery and in breastfeeding, unless the mom uses ART. A typical HIV screening is performed by taking a blood sample or cheek swab, which can be placed through a rapid test (10-20 minutes) or a lab test (two weeks).