removal of their cervix and have
never had cervical cancer or
high-grade precancerous lesions
don’t need screening.
POSSIBLE OUTCOMES: Your
doctor may biopsy abnormal
cells and, if necessary, destroy
them with a laser or extreme
cold, or remove them surgically.
These tests may lead to un-
necessary treatment for women
with false positives, notably
when screenings don’t follow the
recommendations. Testing for
women younger than 21 is more
likely to pick up harmless and
temporary cell changes than
potentially harmful ones.
Prostate Cancer
(PSA) Test
This blood test checks for
elevated levels of the prostate-
specific antigen (PSA) protein
produced in the prostate.
WHY IT’S DONE: High levels may
be caused by prostate cancer.
RECOMMENDED FOR: Those
who’ve already been diagnosed
with prostate cancer, to help
doctors monitor them. Men
in their 50s and 60s might
consider the test after discussing
the risks and benefits with their
doctor, according to guidelines
from the ACS, ACP, and USPSTF.
Exactly when differs from
organization to organization.
The ACS also recommends that
men at higher risk—such as
African-Americans—consider
earlier screening. Men 70 and
older shouldn’t be screened,
according to the USPSTF,
because the risks outweigh the
potential benefits.
POSSIBLE OUTCOMES: Radiation
or prostate-removal surgery for
those who require treatment.
The test, however, often flags
noncancerous conditions such
as an enlarged prostate or
nonaggressive cancers. “Men
should understand before they
have the test that there’s a
chance they may be diagnosed
with a cancer that should just be
watched, rather than treated,”
says Brawley.Skin Cancer Screening
A healthcare provider inspects
your skin visually.
WHY IT’S DONE: For indications of
skin cancer. Rates of melanoma,
the most deadly skin cancer,
have been rising for 30 years.
RECOMMENDED FOR: People
at increased risk—men older
than 50 and people who have
more than 50 moles; those
with large, unusual moles, fair
skin, or reduced immunity; or
those with a personal or strong
family history of skin cancer—
should be screened, according
to the American Academy of
Dermatology. If you’re among
them, talk with a dermatologist
about the frequency. Everyone
should familiarize themselves
with their blemishes, moles, and
freckles, says the ACS, and see a
dermatologist if they note unusual
spots, including those that are
changing, itching, or bleeding.
POSSIBLE OUTCOMES: Your
doctor may biopsy a suspicious
spot. For diagnosed skin cancer,
treatment depends on the type
and extent.Thyroid Cancer
Screening
An ultrasound is used to image
the butterfly-shaped gland in
the front of your neck.
WHY IT’S DONE: To check for
possible cancer of the thyroid.
RECOMMENDED FOR: Those who
have risk factors such as a close
family history of thyroid cancer,
or radiation exposure (such as
radiation therapy), or if you or
your doctor notice a lump in
your neck. Others can skip it,
according to the USPSTF, ACS,
and other organizations.
POSSIBLE OUTCOMES: A scan can
help locate a lump that might
be cancerous, or, for high-risk
patients, find cancers before
they become large enough
to be felt. Most of the time, it
detects harmless nodules or
nonaggressive cancers. A vast
majority of thyroid cancers grow
very slowly. If the scan suggests
cancer and follow-up tests
confirm it, talk with your doctorabout whether treatment is really
needed or whether watchful
waiting is a good option.Type 2 Diabetes
(Blood Sugar) Screening
Two blood tests are commonly
used. A fasting glucose test
measures blood sugar levels after
you’ve gone without calories
for at least 8 hours, and an A1C
test determines your average
blood sugar levels over the past
three months.
WHY IT’S DONE: High levels can
signify diabetes. Slightly elevated
levels indicate prediabetes,
increasing your risk of the full-
blown disease.
RECOMMENDED FOR: People
younger than 45 who are
overweight and have at least
one other risk factor—such
as high blood pressure or
cholesterol, a family history
of diabetes, or a sedentary
lifestyle—should be screened,
according to the American
Diabetes Association (ADA) and
other medical organizations.
If results are normal, retest
every three years; for borderline
high (prediabetes), every one
to two years. One point of
disagreement: For people 45
and older without risk factors,
the ADA recommends screening
but the USPSTF says it’s
unnecessary. David Nathan,
M.D., a professor of medicine at
the Harvard Medical School and
director of the Diabetes Center
at Massachusetts General
Hospital, suggests following
the ADA’s recommendation.
“Screening for diabetes is simple,
safe, and inexpensive,” he notes.
POSSIBLE OUTCOMES: If results
suggest diabetes, you’ll need to
retest to confirm, because many
factors, including medication
and stress, can affect your blood
sugar. If diabetes or prediabetes
is diagnosed, you’ll need to make
dietary and exercise changes.
For diabetes, you’ll probably
need medication, too.Blood
Chemistry
ScreeningThese blood
tests cost
Medicare more
than $1 billion
in 2014.CR.ORGGUIDE TO WELLNESS 57