Guide to Wellness – July 2019

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Medical Tests

50 GUIDE TO WELLNESS CR.ORG

MILLIRON, OF LANCASTER, Pa., benefited from an idea that
took hold as early as the mid-1940s. In the town of Oxford,
Mass., U.S. Public Health Service workers decided to look for
signs of diabetes in people. To do that, they tested the urine
and blood glucose of almost three-quarters of the town’s
4,983 residents. One goal was to show that early detection
of diabetes through mass screening could prevent such life-
altering complications as heart disease and nerve damage.
Within a few years, diabetes screening was being done across
the U.S., and similar tests for other diseases quickly followed.
Today, as we’ve learned more about how to detect disease
early, there are scores of blood tests, ultrasounds, and CT
scans to screen for conditions like cancer and low bone den-
sity. And an increasing number are offered direct-to-consumer
(DTC), leaving you to pick—and pay for—screenings.
The surge of interest in testing is propelled by “a trend
toward people being proactive about taking better care of
themselves,” says Alex Krist, M.D., a professor of family med-
icine at Virginia Commonwealth University and vice chair-
person of the U.S. Preventive Services Task Force (USPSTF),
an independent expert panel that makes recommendations
to the government and medical organizations about preventive
care. Generally, he notes, that’s a good thing. “Screening
tests that have been shown to help people live longer or bet-
ter are an enormous boon to public health.”
As with Milliron’s colonoscopy, a screening test could spare
you the physical, emotional, and financial pain of dealing with
a serious illness—and maybe even save your life. As just one
example, screenings done at the right age and frequency can
cut the risk of colorectal cancer death by as much as half,
according to the American Cancer Society (ACS). That blood
pressure check you get during a routine physical? If it reveals
hypertension and you get it treated, you might reduce your
heart attack and stroke risk by more than 20 percent.
The trouble is, too few people are getting the right tests.
Overall, Americans get only half the preventive care—includ-
ing screenings—that they should, the Centers for Disease
Control and Prevention (CDC) reports. Many other people
are screened too frequently, at the wrong age, or with tests
that aren’t very accurate. “We have a problem in this country
where we both underscreen and overscreen,” says Susie
Dade, M.P.A., deputy director of the nonprofit Washington
Health Alliance (WHA).
For example, evidence-based guidelines from the USPSTF
call for a one-time osteoporosis screening for most women
ages 65 and older, and no screening for younger women
at low risk for the bone-thinning disease. A 2015 study, how-
ever, found that almost half of low-risk women in their 50s
had the screening, while 4 of 10 women between ages 65 and
74 and 6 in 10 women 75 and older had not.
Medical screenings aren’t an exact science, and therein
lies the rub. All screenings, though some more than others,
may still miss problems. The ACS notes, for example, that

Just before her father


died of colon cancer,


Lynne Milliron, then


age 40, made him a


solemn promise:


She would get herself


screened for the


disease. Two months


later, Milliron had


that colonoscopy—


and is profoundly


grateful she did.


“The doctor removed


a large, precancerous


polyp,” she says.


“That test probably


saved my life.”

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