The Skinny on Screening Exams

symptoms-solutionsPrevention is the best treatment for disease.  In the words of one of my mentors, “would you wait and dig a well once the drought has started? No, you prepare for the drought by digging the well early.” Such is the fact with our health. Maintaining a healthy lifestyle and diet is key to preventing future disease. But we are also exposed to many things outside of our control that can cause health problems which is why getting screening exams is an important part of that healthy lifestyle.

Not sure if you’re staying up to schedule on screening exams?  Read ahead and find out if you’re getting testing done too often, or not enough.  Some people may need to veer from the recommended timing if they have certain risk factors.  Speak with your physician to find out what is best for you and your health.

Bone Density Testing

Reduce your risk of getting a fracture and keep your body moving healthy and strong! Bone density testing helps detect osteoporosis which is especially important for woman in the post menopausal years.

Age 65: This is the recommended age that women start getting screened for osteoporosis. The current best screening test is the Dexa scan.

Less than age 65: There are some reasons that you may need to be screened for osteoporosis earlier. These include: history of smoking, excessive alcohol use, a family history of osteoporosis, low body weight, and thyroid disease. Talk to your doctor if you fall in to any of these categories.

How often?  Once you’ve had your first screening exam, your physician will decide how often you need to repeat the test depending on what the results were. One thing to consider with the Dexa scan is that different machines can give out different readings. After you’ve had your first screening, it is best to get scanned at the same facility as different machines can give you a false idea of gaining or losing bone mass.

Pap Smears and HPV Testing

Check out the new guidelines below, it’s no longer necessary to get a pap every year!  Read more about Pap guidelines.

Below age 21: Even for women who are sexually active, it is not recommended to get pap smears before the age of 21.

Age 21-29: Beginning at age 21, getting a pap every three years is sufficient for cancer screening.

Age 30-65: At age 30, screening for HPV becomes important. This test can simply be done with your pap smear. If you are screened for HPV and both the HPV and your pap smear comes back negative, then you will not need to get another pap smear for another five years. It is important to remember to continue getting annual exams even if you aren’t getting a pap smear. If you do not get the HPV testing done, then getting a pap smear every three years is still recommended.

Age 65 and above: If you don’t have significant risk factors and haven’t had an abnormal pap smear in the previous 20 years, then a pap smear after 65 years is not recommended any longer.

Colon Cancer Screening

The best way to prevent colon cancer is to keep your bowels moving well by eating lots of fiber, drinking adequate water and staying active.

Age 50-75: It is recommended to start getting screened for colon cancer beginning at age 50. The type of screening tool your physician chooses and your risk factors for colon cancer will help decide how often you will get the screening test.

Above age 75: It is no longer recommended to get screened unless you have significant risk factors.

How often?  There are different types of screening exams for colon cancer and each one can happen at a different time increment. The following timeline is for someone with an average risk of developing colon cancer. Risk factors that would increase your chance of colon cancer and warrant more testing include a family history of colon cancer, inflammatory bowel disease (IBD), a personal history of colon polyps, and a sedentary lifestyle. Talk with your physician about which test is best for you.

  • Fecal Occult Blood Testing: This test is recommended every year. It consists of taking a small sample from three consecutive stool samples. This test can be done in the comfort of your own home and sent in to the lab.
  • Sigmoidoscopy: This test is recommended every five years. It consists of a scope that allows the physician to view the lower part of the colon and the rectum. Although it has great accuracy, if polyps are found in the lower part of the colon then it is assumed there are more in other parts of the colon and you may be referred for a full colonoscopy.
  • Computed tomographic (CT) Colonography: This test is recommended every five years. The advantage of this screening tool is that it is non-invasive and uses a series of pictures to determine if there is cancer in the colon.
  • Colonoscopy: This test is recommended every 10 years. This form of screening is advantageous because the physician is able to view the entire colon and if polyps are found, they are usually able to remove them during the procedure.


Breast tissue has a lot of lymph tissue in it.  Our lymph system moves toxins out of the body. Keep your lymph moving adequately every day by staying active!

Age 20: The American Congress of Obstetricians and Gynecologists recommends starting self breast exams at this age.

Age 40: As long as you don’t have any significant risk factors such as a primary family member with breast cancer or the BRCA gene then 40 years old is the best time to begin mammogram screening.

How often?  In the last two years there has been a change in the screening guidelines. Currently it is recommended to get annual mammograms beginning at age 40, instead of age 50. Depending on your risk factors, your physician may chose to have you get a mammogram every two years until age 50 and then start annual mammograms.

Annual Exams

Make your voice heard at your annual; make sure to ask all your questions so that you can maintain the health you want.

Age 21 is the recommended starting age. It will always be as it says, annual. While you may not need to get a pap smear, the annual exam is still an important preventative tool. Your physician can do a screening exam to check the health of organs like your thyroid, abdomen heart and lungs. They also will do a vaginal exam to check for the skin health in areas that are hard to see (melanoma can grow on the vagina!) and do a bimannual exam which checks for the uterus and health of the cervix.

The annual exam is a great time for you to spend some time talking to your physician asking questions about your health.  If you don’t regularly see the doctor, you can also talk to them about getting screening blood tests like getting your cholesterol or vitamin D levels checked.

By Angela Potter, NCNM Naturopathic Medicine Program Edited by Dr Elise Schroeder