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CR.ORG GUIDE TO WELLNESS 55Douglas, M.D., a professor
of research in cardiovascular
disease at Duke University.
Those older than 75 should talk
with a doctor about whether
screening makes sense based
on their overall health.
POSSIBLE OUTCOMES: Test
results, along with other heart
risk factors, may help your
doctor determine whether you
may benefit from medication.Colorectal Cancer
Screening
Your healthcare provider may
prescribe a take-home kit;
you send a stool smear to be
checked for hidden blood or
DNA markers for cancer. But the
gold standard is a colonoscopy,
an outpatient procedure that
typically involves a sedative. A
gastroenterologist uses a tube
with a small camera attached to
examine the inside of your colon.
Sigmoidoscopy, which examines
only the lower third of the colon,
and CT colonoscopy, which
uses multiple X-rays to image
the colon, are used less often.
WHY IT’S DONE: To detec t
colon polyps, which can become
cancerous.
RECOMMENDED FOR: Generally
starting at age 50, although the
American Cancer Society (ACS),
citing an increase in colorectal
cancer in younger people,
recently recommended a first
screening at age 45. “If you
are worried about colorectal
cancer or you’re at higher
risk because you have family
members diagnosed in their
40s and 50s, that may tip your
decision in favor of screening
before 50,” says Otis Brawley,
M.D., the former chief medical
and scientific officer of the ACS.
That group’s recommendations
include screening every 10 years
with colonoscopy, every five
years with sigmoidoscopy, or
every one to three years with
stool tests (depending on the
type). People ages 76 to 85
should talk with their doctor
about whether screening
makes sense. At 80,colonoscopy risks such as
colon tears and anesthesia
complications rise.
POSSIBLE OUTCOMES: Suspicious
findings on any of the less
invasive screenings, including
sigmoidoscopy, will usually
mean you’ll be advised to have
a colonoscopy.Electrocardiogram (EKG)
and Exercise Stress Tests
With an EKG, electrodes
attached to your chest measure
your heart’s electrical activity.
In an exercise stress test, you
have an EKG while on a tread-
mill or stationary bike, or after
taking medication to make your
heart beat harder and faster.
WHY IT’S DONE: To check
for signs of heart disease or
arrhythmias.
RECOMMENDED FOR: Those at
high risk of heart disease or
those with suspected heart
disease or symptoms such
as chest pain or shortness of
breath, as a diagnostic tool. For
others, major medical groups
don’t recommend the tests,
which doctors sometimes do
during routine physicals.
POSSIBLE OUTCOME: For people
with heart disease or symptoms,
these tests may help determine
the risk of a cardiac event. In
low-risk people with no symptoms,
they can lead to inaccurate results
and unnecessary procedures,
such as angiography (a heart
X-ray) or angioplasty (treatment
to open an artery).Full-Body CT Scans
These use multiple X-rays to image
the body and internal organs.
WHY IT’S DONE: They’re typically
marketed as a way to detect
early signs of cancer, heart
disease, and other conditions.
RECOMMENDED FOR: The
American Medical Association,
among others, advises against
these except in rare instances,
and not for healthy people.
Those rare cases may includeCarotid Artery
Screening
This is an ultrasound of the
artery on each side of your neck.
WHY IT’S DONE: Artery
narrowing can lead to a higher
stroke risk.
RECOMMENDED FOR: Anyone
with symptoms of a stroke or
ministroke. People without
symptoms can skip this.
POSSIBLE OUTCOMES: If a scan
suggests a blocked carotid
artery, you could get follow-up
tests such as an MRI to confirm.
Treatment can entail medi-
cation or surgery to clear out
the artery. Severely narrowed
carotid arteries are found in
only about 1 percent of adults
and even then rarely lead to
a stroke unless there are other
risk factors, such as high blood
pressure. For people without
symptoms, screening can lead to
false positives, and “studies show
it actually winds up hurting more
people than it helps,” says
Alex Krist, M.D., vice chairperson
of the USPSTF.Cholesterol Screening
This blood test measures total
cholesterol levels, including
LDL (bad) cholesterol, HDL (good)
cholesterol, and triglycerides
(artery-clogging fatty acids).
WHY IT’S DONE: Unhealthy
levels—particularly total
cholesterol above 240 mg/dL
and LDL above 190 mg/dL—
increase heart disease and
stroke risks.
RECOMMENDED FOR: Adults
ages 40 to 75 with one or
more cardiovascular disease
risk factors, such as smoking,
high blood pressure, and
diabetes, should be tested
every five years, and more
often if results are outside the
healthy range, according to
the USPSTF. “It’s a good idea
for people younger than 40
with heart-disease risk factors
or a family history of very high
cholesterol to get screened at
least once,” says PamelaHepatitis C
Screening
A blood test that
checks for this
viral infection.WHY IT’S DONEHepatitis C can
linger in the body,
symptomless, for
years. Half of the
people with it are
unaware. Early
detection and
treatment prevent
complications such as
liver damage, cancer,
and even death.RECOMMENDED FORAnyone who was born
between 1945 and
1965, had a blood
transfusion before
1992, or used IV
recreational drugs.POSSIBLE OUTCOMESIf you test positive,
another blood test
(hepatitis C virus RNA)
is needed to confirm
the diagnosis. The
virus clears up on its
own in about 15 to 25
percent of cases. For
those who need it,
antiviral medication
cures the disease more
than 90 percent of
the time.