Women’s Health Screenings: What You Need and When

by Michelle Abbo, M.D., Scripps Memorial Hospital La Jolla

The earlier we can detect and diagnose most diseases, the greater our chances of successfully treating them. This is especially true with problems such as breast cancer, cervical cancer, hormonal issues and other conditions that affect mostly women.

Health screenings are an important part of any woman’s medical care throughout her lifetime. While factors such as age, genetics and lifestyle may affect your individual risk, the following screenings are generally recommended for most women.

Human Papillomavirus (HPV) Test, Annual Pelvic Exams and Pap Smear
HPV is a sexually transmitted disease that, in some cases, can lead to cervical cancer over time. An HPV test can identify high-risk strains of the HPV virus. While HPV may cause genital warts in some people, most don’t have symptoms or know they are infected, so it is important to be tested. Recently, the FDA approved Gardasil, an HPV vaccine that can protect against some of the high-risk strains of the virus. The vaccine is most effective when given to women between the ages of 11 and 26.

An abnormal Pap smear is the result of ongoing HPV infection. Starting no later than age 18, you should undergo annual STD screening, including a pelvic exam and Pap smear. In your 30s, HPV testing should become a routine part of this screening. If your Pap smear or HPV test comes back with an abnormal result, either a repeat Pap smear or referral to an OB/GYN for further testing may be indicated.

Blood Pressure Screening
High blood pressure, or hypertension, is a very common condition that increases the risk of heart attack and stroke. Prevention is the best way to avoid damage and disease occurrence, and an annual blood pressure screening can monitor your risk of hypertension and related health problems. Normal blood pressure is less than 120/80; if yours is above normal, your physician can recommend lifestyle changes or medications to help lower your blood pressure and decrease your risk. You should perform this screening in your 30s.

The American Cancer Society recommends women have a mammogram to screen for breast cancer every one to two years starting at age 40; if you have a family history of breast cancer or know you are at a higher risk of developing the disease, your physician may recommend having your first baseline mammogram earlier. Your physician may also recommend digital mammography, which provides clearer definition and a more accurate image, if your breast tissue is dense or you are pre-menopausal. A combination of mammography and breast Magnetic Resonance Imaging (MRI) may be recommended for very high-risk women.

Cholesterol Screening
If you have too much LDL or “bad” cholesterol in your bloodstream, it can slowly build up in the walls of your arteries and prevent blood from flowing freely. This is known as atherosclerosis or hardening of the arteries, and can cause a heart attack or stroke. Conversely, low levels of HDL or “good” cholesterol can also increase your risk of heart disease. We believe that HDL helps keep LDL levels in check, so too little of it can be a problem. Start testing cholesterol in your 40s: Ideally, your LDL levels should be less than 100, while your HDL should be above 45. Your non-HDL cholesterol, which should be less than 130, is a more important predictor of developing cardiovascular disease than your total cholesterol or LDL alone.

There are also other independent risk factors for having a heart attack or stroke, such as C-reactive protein, that should be measured annually along with your cholesterol profile. You will not feel damage accruing over the years, but at a level of 135/85, you have double the risk of developing a heart attack or stroke compared to a person whose blood pressure is 115/75. The risk increases with increasing blood pressure.

The “gold standard” screening for colon cancer, colonoscopy tests for cancer, precancerous growths or abnormal changes in the lining of the colon. If anything unusual is found, it can often be removed during the procedure as well. Colonoscopy should be performed at age 50, but if you have a family history of colon cancer, you doctor may want you to have your first colonoscopy earlier

While these tests are commonly recommended for most women, every individual is different. Talk to your physician about which screenings are right for you.

About Dr. Michelle Abbo

Michelle Abbo, M.D., is an internal medicine physician at Scripps Memorial Hospital La Jolla. Join Dr. Abbo and 10News anchor Carol LeBeau for brunch, health screenings and important information every woman should know about her health at the It’s All About You — Women’s Health Expo on May 2, from 10 a.m. to 1 p.m. This interactive event will feature educational materials and services, a chance to speak with women’s health experts, entertainment and giveaways. Call 1-800-SCRIPPS to register as seating is limited.

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