Your Health Screening Guide for Every Decade

Importance of Preventative Health Care

Benjamin Franklin famously said, “An ounce of prevention is worth a pound of cure.” And although that was more than two centuries ago, it still holds true today — especially when it comes to healthcare.

“Quality healthcare for individuals includes two fundamental elements: appropriate treatment for current illness and appropriate preventive care to attempt to lessen future health decline,” says Dr. Karnika Kapoor, DO, primary care physician at Medical Offices of Manhattan. “Preventive healthcare is an important aspect of medical practice, leading to significant improvements in overall health in the United States.” According to Healthy People, a federal program administered by the United States Department of Health and Human Services, routine cardiovascular examinations alone save tens of thousands of adult lives every year. Preventive health screenings and primary care consultations have also been found to significantly increase life expectancy, particularly among those in their 30s and 40s. Yet, according to the Centers for Disease Control and Prevention, Americans use preventive services only at about half the recommended rate — leaving themselves vulnerable to potentially preventable conditions.

“Preventive services should focus on priority health problems and effective interventions,” says Kapoor. “Rather than performing a standardized comprehensive examination (aka, a full physical) on all patients, clinicians should individualize screening and prevention interventions to maximize value, which encompasses the tradeoffs between benefits, harms, and costs.”

As you age, your medical needs evolve. And as you might suspect, your gender plays a significant role in determining those needs. Kapoor breaks down each decade of life and what screenings your physician should consider in order to prevent — or catch in the earliest stage possible — a range of medical issues:

20s Screenings:

• Hyperlipidemia (high cholesterol): Should be screened once between 17 and 21; women under 35 and men under 25 with risk factors (obesity, diabetes, a family history of high cholesterol, and smoking) should be screened. Total cholesterol should be less than 200 — HDL (the good stuff) should be 40 or higher, LDL (the bad stuff) should be less than 100, and triglycerides should be less than 149.
• Diabetes: Should be screened for adults with hypertension (high blood pressure) or hyperlipidemia (high cholesterol).
• Cervical cancer: Women aged 21 to 29 should get pap smears every three years.
• Chlamydia and gonorrhea: Should be checked in sexually active women 25 and younger; women and men at increased risk (unprotected sex) for these STDs should be screened over the age 25.

30s Screenings:

• Hyperlipidemia (high cholesterol): Women under 35 with risk factors (obesity, diabetes, a family history of high cholesterol, and smoking) and men under 35 without risk factors should be screened. Total cholesterol should be less than 200 — HDL (the good stuff) should be 40 or higher, LDL (the bad stuff) should be less than 100, and triglycerides should be less than 149.
• Diabetes: Should be screened for adults with hypertension (high blood pressure) or hyperlipidemia (high cholesterol).

40s Screenings:

• Hyperlipidemia (high cholesterol): Women under 45 without risk factors should be screened.
• Diabetes: Should be screened for adults with hypertension (high blood pressure) or hyperlipidemia. It should also be screened for adults aged 40 to 70 years with a BMI greater than 25.
• Breast cancer: Should be screened in anyone with concerning family history, with hereditary breast and ovarian syndrome, or women over 40.
• Prostate cancer: Should be screened for men aged 40 to 45 years with high risk (those with a family history, African Americans, and those consuming a high-fat and highly processed diet); and men 50 years or older without risk factors.

50s Screenings:

• Diabetes: Should be screened for adults with hypertension or hyperlipidemia. It should also be screened for adults aged 40 to 70 years with a BMI greater than 25.
• Osteoporosis: Should be screened in postmenopausal women under 65 years of age with risk factors (smoking, excessive drinking, inactive lifestyle, heavy caffeine use, and insufficient calcium and vitamin D); men with clinical manifestations of low bone mass (fractures, height loss) should be screened.
• Breast cancer: Should be screened in women over 40.
• Colorectal cancer: Should be screened for patients over 50 without risk factors.
• Lung cancer: Should be screened for patients 55 to 74 years of age, those who had a pack-a-day habit for 30 years, those currently smoking, and those who have quit in the past 15 years.
• Hepatitis C: Should be screened in patients born in the United States between 1945 and 1965 and patients with risk factors (family history, alcoholism, drug use, or cirrhosis of the liver).

Immunization in Your 50s

• Shingles: Herpes zoster vaccine once after age 50.

60s+ Screenings:

• Driving: Screen for driving problems in those with vision, mobility, or cognition issues.
• Support: Regular screening for financial and social support, and routine direct questioning about problems with abuse or neglect.
• Osteoporosis: Screening densitometry for osteoporosis for women at age 65.
• Abdominal aortic aneurysm (AAA): One-time screening ultrasound in men aged 65 to 75 with any history of smoking or family history of AAA requiring repair.
• Hypertension (high blood pressure): Screen adults (to age 70) with a BMI greater than 25, hypertension, or hyperlipidemia.
• Breast cancer: If a woman opts to be screened, biennial mammography if life expectancy is at least 10 years.
• Colorectal cancer: Screening includes a colonoscopy every 10 years and/or flexible sigmoidoscopy every five years as long as life expectancy is at least five years.
• Cervical cancer: May safely discontinue Pap smears at or after age 65 after three consecutive “normals” within a 10-year period.
• Lung cancer: Annual low-dose chest CT scan for high-risk individuals up to age 80 who have a history of smoking or family history of lung cancer; discontinue if person has not smoked for 15 years or if life expectancy is limited.

Immunization in Your 60s

• Tetanus-diptheria vaccine booster every 10 years in patients who have received primary series (alternative: booster once after age 50); Tdap once.
• Pneumococcal vaccine (PCV13 and PPSV23) — Give PCV13 followed by PPSV23 6 to 12 months later, once after age 65. Revaccinate PPSV23 once after age 65 if an initial vaccination was given before age 65 and five years have elapsed since the first dose.
• While these suggestions serve as a loose guide to follow, it doesn’t preclude you from experiencing symptoms of conditions earlier or differently than indicated for each decade. “Some of the red flags for patients to watch out for are unintentional weight loss, appetite loss, excessive hair loss, or blood in the stool or urine,” says Kapoor. “They should make their doctors aware of this as soon as they can.”

Health Screenings For All Ages

Dr. Karnika Kapoor, DO, says that other preventive measures men and women of all ages can take to reduce risk of disease include:

Melanoma (skin cancer): Should be screened in high-risk patients, such as those with a history of sunburn, those who have had excessive exposure to UV light (tanning beds), people with fair skin, and those whose skin always burns and never tans. Conduct a thorough examination of your skin monthly, and visit a dermatologist for a professional examination annually. You should familiarize yourself with the pattern of moles, blemishes, freckles, and other marks on your skin so that you’ll notice any new moles or changes in existing moles — if you find anything suspicious, notify your dermatologist right away.

Obesity: Should be screened in all the patients with BMI of of 25 or greater. This measure of body fat takes into account your height and weight, and free calculators are readily available online. You should strive for a BMI of 18.5 to 24.9. Anything lower is considered underweight, while anything above 25 moves into the overweight and then obese categories.

Cervical cancer: Women over 30 years should get a pap smear every three years or pap smear + HPV testing every five years. There are 100+ types of human papillomavirus (HPV), and about 40 of those strains are spread during sexual contact, infecting your genital area as well as your mouth and throat. About 79 million Americans are currently infected with HPV and about 14 million new people become infected annually. In some cases, HPV goes away on its own, but other times it causes health problems like genital warts and cancer.

Hypertension: Should be assessed in all patients, as uncontrolled high blood pressure can lead to stroke, memory loss, and damage to the eyes and kidneys. Roughly one in three U.S. adults has high blood pressure. A normal reading is 120/80 mm Hg; a reading of 180/120 or greater is cause for concern.

Hepatitis B: This viral infection that can cause both acute and chronic liver disease should be screened in patients with risks factors (drug users, those working in the healthcare field, those having unprotected sex, and those who have traveled to regions with high infection rates, such as Asia and Africa).

HIV: Should be screened in all patients. Being in a monogamous relationship can help reduce your risk of getting HIV if you and your partner first establish that you are both HIV-negative. However, annual testing for HIV is good sexual health practice for everyone who is sexually active. Depending on the number of sexual partners you have in any one year, you may choose to get tested more regularly. In 2013, people aged 55 and older accounted for 26% of all people living with diagnosed or undiagnosed HIV infection in the United States.

Syphilis: Should be screened in patients with risk factors, such as those engaging in unprotected sex with multiple partners. This sexually transmitted disease (STD) is caused by an infection with bacteria known as Treponema pallidum. While the disease starts as a painless sore, if left untreated, it could eventually damage your brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. In addition, pregnant women with syphilis can transmit the infection to their unborn child.

Alcoholism: Should be screened in all patients. Screening usually involves a physician asking four questions: Have you ever felt you need to cut down on your drinking? Have people annoyed you by criticizing your drinking? Have you ever felt guilty about drinking? Have you ever felt you needed a drink first thing in the morning to steady your nerves or to get rid of a hangover?

Tobacco usage: Should be screened in all patients. Whether you smoke regular cigarettes, electronic ones, a pipe, cigars or chew tobacco, it’s time to kick the habit. People who smoke cigarettes are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who do not smoke. And lung cancer isn’t the only concern — cigarette smoking also causes cancer of the mouth and throat, esophagus, stomach, colon, rectum, liver, pancreas, trachea, and kidney. Think bumming a smoke from your friend occasionally doesn’t matter? A recent study shows that participants who reported consistently smoking 1 to 10 cigarettes per day over their lifetime were at substantially higher risk of premature mortality from a broad spectrum of smoking-related causes of death than those who never smoked.

Drug use and intimate partner violence (IPV): Should be screened for everyone. Substance abuse has been found to occur in 40 to 60% of intimate partner violence incidents, because it precipitates or exacerbates violent behavior. Victims of intimate partner violence are at increased risk for suffering serious mental health problems, and victims of IPV are more likely to use tobacco and marijuana. Additionally, several studies suggest a significant correlation between IPV, morbid obesity, and disturbed eating behaviors.

His and Hers Supplements 

Men and women have some differences in their nutritional needs, and should consider taking the following supplements to ensure optimum health:

Essential Nutrtients for Men & Women

Vitamin B12: As you age, decreasing dietary intake and absorption make it tough to get all of your B vitamins, including B12, B6, and folate — all of which are crucial for the metabolism of carbohydrates, protein, and fat. Of those, B12 deserves the most attention for its benefits to brain development and memory function as well as keeping your metabolism in check.

Omega 3: Fish oil is one of the best sources of omega-3 fatty acids, which are crucial for brain and heart health and act as a natural anti-inflammatory agent as well.

Probiotics: These are good bacteria — the same kind found in your intestine — that aid with overall gut health and enhance your immune system. If your diet isn’t rich in yogurt, fermented and unfermented milk, miso, and soy beverages, taking a probiotic supplement is very helpful.

Vitamin D: Alongwith boosting bone health, this vitamin may help prevent diabetes, metabolic syndrome, multiple sclerosis, certain cancers and other health conditions.

Collagen: Collagen is the most abundant protein in the body, and it’s responsible
for regenerating and forming new tissue. As we age, collagen fibers start to break down and the rate of regeneration slows dramatically. Supplementing with collagen has been shown to protect against bone and joint degenerative diseases and fight skin aging.

Just for Him

Multivitamin: A complete men’s multi-vitamin, which is helpful for those whose diets fall short, should contain more than 20 different vitamins and minerals and meet 100 percent or more of the daily value for vitamins C, D, B6, B12, riboflavin, folic acid, pantothenic acid, zinc, selenium, copper, manganese and chromium.

Testosterone Support: Testosterone regulates everything from more muscle to less fat, sex drive, and bone density. But testosterone levels naturally decline steadily after the age of 40. Other factors like obesity, stress, alcohol use, inactivity, and lack of quality sleep can advance the decline as well. Support healthy testosterone levels and increase energy at the cellular level with ingredients like fenugreek and cordyceps to improve blood flow and strengthen the adrenal glands.

Just for Her

Multivitamin: A complete women’s multivitamin helps with healthy nervous system, strong immune system, and defense against aging. It also helps with beautiful skin, balanced mood, and restoration of iron reserve lost during the menstrual cycle. Women who are pregnant have increased nutritional and vitamin needs, so a prenatal multi can help bridge that gap.

Calcium: Women are especially vulnerable to osteoporosis later in life, so it is important to add calcium to your diet to promote strong and healthy bones. It is recommended that women under 50 years of age consume at least 1,000 mg a day, and women over 50 should have at least 1,500 mg a day.