Many men in Anguilla are reluctant to have regular medical check-ups and few are keen to have recommended screening tests.Getting the right screening test at the right time is one of the most important things a man can do for his health.
What is a screening test?
In the health field screenings tests find diseases early, before individuals have symptoms, when they are easier to treat. The tests you need are based on your age and risk factors. Some screening tests are controversial and in these cases individuals are advised to discuss with their doctor about the particular screening test.
High Blood Pressure (Hypertension)
A large proportion of men in Anguilla have high blood pressure. Unfortunately, many men do not know they have this disorder as there might be no symptoms at all. High blood pressure is often called ‘the silent killer’.
The risk for high blood pressure increases with age. It is also related to weight and lifestyle. High blood pressure can lead to severe complications without any prior symptoms, including an aneurysm — dangerous ballooning of an artery. The good news is that high blood pressure can be treated. When it is, you may reduce your risk for heart disease, stroke and kidney failure. It is important that all of us know what our blood pressure is. If it is high, work with your doctor to manage it.
Screening for High Blood Pressure
Blood pressure readings give two numbers. The first (systolic) is the pressure in your arteries when the heart beats. The second (diastolic) is the pressure between beats. Normal blood pressure is less than 120/80. High blood pressure is 140/90 or higher, and in between those two is prehypertension — a major milestone on the road to high blood pressure. How often blood pressure should be checked depends on how high it is and what other risk factors you have.
Cholesterol Levels
A high level of LDL cholesterol in the blood causes sticky plaque to build up in the walls of the arteries. This increases your risk of heart disease. Atherosclerosis — hardening and narrowing of the arteries — can progress without symptoms for many years. Over time it can lead to heart attack and stroke. Lifestyle changes and medications can reduce this “bad” cholesterol and lower the risk of cardiovascular disease.
Determining Cholesterol Levels
The fasting blood lipid panel is a blood test that tells your levels of total cholesterol, LDL “bad” cholesterol, HDL “good” cholesterol and triglycerides (blood fat). The results tell you and your doctor a lot about what you need to do to reduce the risk of heart disease, stroke and diabetes. Starting at age 20, men should be screened if they are at increased risk for heart disease. Starting at 35, men need regular cholesterol testing.
Type 2 Diabetes
Many residents of Anguilla have diabetes and do not know they have it. Uncontrolled diabetes can lead to heart disease and stroke, kidney disease, blindness from damage to the blood vessels of the retina, nerve damage and impotence. This can be avoided. Especially when found early, diabetes can be controlled and complications can be avoided with diet, exercise, weight loss and medications.
Screening for Type 2 Diabetes
A fasting blood sugar test, glucose tolerance test or an AIC can all be used alone or together to screen for diabetes. Healthy adults should have the test every three years starting at age 45. If you have a higher risk, including high cholesterol or blood pressure, you may start testing earlier and more frequently.
Prostate Cancer
Prostate cancer is the most common cancer found in men in Anguilla. It tends to be a slow-growing cancer, but there are also aggressive, fast-growing types of prostate cancer. Screening tests can find the disease early, sometimes before symptoms develop when treatments are most effective.
Tests for Prostate Cancer
Screenings for healthy men may include a digital rectal exam (DRE) and possibly a prostate specific antigen (PSA) blood test. Some groups and organizations recommend against the routine use of the PSA test. The American Cancer Society advises each man to talk with a doctor about the risks and possible benefits of the PSA test. Discussions should begin at:
• 50 for average-risk men.
• 45 for men at high risk.
• 40 for men with a strong family history of prostate cancer.
Testicular Cancer
This uncommon cancer develops in a man’s testicles, the reproductive glands that produce sperm. Most cases occur between ages 20 and 54. It is recommended that all men have a testicular exam when they see a doctor for a routine physical. Men at higher risk (a family history or an undescended testicle) should talk with a doctor about additional screening. Some doctors advise regular self-exams – gently feeling for hard lumps, smooth bumps, or changes in size or shape of the testes.
Colorectal Cancer
Colorectal cancer is a common cause of death from cancer. Men have a slightly higher risk of developing it than women. The majority of colon cancers slowly develop from colon polyps: growths on the inner surface of the colon. After cancer develops, it can invade or spread to other parts of the body. One way to prevent colon cancer is to find and remove polyps before they turn cancerous. Diet and exercise might also influence the development of colorectal cancer.
Tests for Colon Cancer
Screening begins at age 50 in average-risk adults. A colonoscopy is a common test for detecting polyps and colorectal cancer. A doctor views the entire colon using a flexible tube and a camera. Polyps can be removed at the time of the test. A similar alternative is a flexible sigmoidoscopy that examines only the lower part of the colon. Stool tests looking for blood is no longer recommended as effective screening test for colon cancer.
Human Immunodeficiency Virus (HIV)
HIV is the virus that causes AIDS. It is in the blood and other body secretions of infected individuals, even when there are no symptoms. It spreads from one person to another when these secretions come in contact with the vagina, anal area, mouth, eyes or a break in the skin. There is still no cure or vaccine for AIDS. Modern treatments can keep HIV infection from becoming AIDS.
HIV Screening Tests
HIV-infected individuals can remain symptom-free for many years. The only way to know they are infected is with a series of blood tests. The first test is called ELISA or EIA. It looks for antibodies to HIV in the blood. It is possible not to be infected and still show positive on the test. So a second test called a Western blot assay is done for confirmation. If you were recently infected, you could still have a negative test result. Repeat testing is recommended. If you think you may have been exposed to HIV, ask your doctor about the tests.
Preventing the Spread of HIV
Most newly infected individuals test positive by two months after infection. But up to 5% are still negative after six months. Safe sex — abstinence or always using latex barriers such as a condom or a dental dam — is necessary to avoid getting HIV and other sexually transmitted infections. If you have HIV and are pregnant, talk with your doctor about what needs to be done to reduce the risk of HIV infection in your unborn child.
Glaucoma
This group of eye diseases gradually damages the optic nerve and may lead to blindness — and significant, irreversible vision loss can occur before people with glaucoma even notice any symptoms. Screening tests look for abnormally high pressure within the eye, to catch and treat the condition before damage to the optic nerve.
Glaucoma Screening
Eye tests for glaucoma are based on age and personal risk:
• Under 40: Every 2-4 years
• 40-54: Every 1-3 years
• 55-64: Every 1-2 years
• 65 up: Every 6-12 months
Talk with a doctor about earlier, more frequent, screening if you fall in a high risk group, including men of African descent, those with a family history of glaucoma, previous eye injury or use of steroid medications.
Conclusion
Men are encouraged to see their doctor on a regular basis even if they do not have any symptoms. During your visit, talk to your doctor about the various screening tests that are available and appropriate for you. Screening tests are important in detecting various disorders at an early stage and allow for effective treatment. There are a number of screening tests on the market, but not all screening tests have been shown to benefit the person being screened. Over-diagnosis, misdiagnosis, and creating a false sense of security are some potential adverse effects of inappropriate screening. Appropriate screening tests are an important part of preventive healthcare.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).