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Health Screening: Finding Health Problems Early

Topic Overview

Why is it important to find health problems early?

Often, the earlier a disease is diagnosed, the more likely it is that it can be cured or successfully managed. When you treat a disease early, you may be able to prevent or delay problems from the disease. Treating the disease early may also make the disease easier to live with.

How do you find health problems early?

Your doctor may suggest:

  • Screening tests, which find health problems before symptoms appear. Examples of screening tests include mammograms to find breast cancer and colonoscopy to find colon cancer.
  • Diagnostic tests, medical exams, and self-exams, which find a disease or other health problem early in its course.

What health problems should you be tested for?

You and your doctor can use recommendations made by expert panels of health professionals to help you decide what screening tests you need. These panels develop screening recommendations based on:

  • Age, health, and gender.
  • Risk factors. Risk factors are things that make getting a disease more likely. They may include family history, such as having a close relative with cancer, and lifestyle habits, such as smoking. Cholesterol screening, for example, is recommended for people who have a family history of early coronary artery disease.
  • Whether or not you are pregnant. A woman who is pregnant or trying to become pregnant may be screened for genetic conditions and other conditions that may affect her or her baby.

Sometimes different expert panels make different recommendations. In these situations, talk with your doctor to decide which guidelines best meet your health needs.

See which screening tests you may need:

Interactive Tool: Which Health Screenings Do You Need?

How do you decide when to get a screening test?

When and how often you get screening tests may depend on your age, your gender, your health status, your risk factors, and the cost of testing. Your doctor may suggest screening tests based on expert guidelines. In some cases, testing is done as part of a routine checkup.

When you are thinking about getting a screening test, talk with your doctor. Find out about the disease, what the test is like, how the test may help you or hurt you, and how much the test costs. You may also want to ask what further testing and follow-up will be needed if a screening test result shows a possible problem.

Ask your doctor about the limits of the test and treatment. For example:

  • Ask your doctor how likely it is that the test would miss a disease (false negative), show something that looks like you have a disease when you don't (false positive), or find a disease that will never cause a problem.
  • Ask your doctor about the treatment for the disease. There may be no treatment that helps with symptoms or helps you live longer. In this case, you may decide that you don't want the screening test.

Also think about what you would do if a test shows that you have the disease. For example, if you are going to be tested for osteoporosis, are you willing to take medicine or make lifestyle changes if the test shows that you have it?

Screening, Birth to 12 Months

Newborn screening tests

All states require newborn screening, although the tests required vary from state to state. These tests can help find serious problems that could affect your baby's long-term health. They may include:

Well-baby visits

It's important for your baby to have regularly scheduled checkups, often called well-baby visits, starting shortly after birth. During these visits, the doctor examines your baby for possible problems and asks you questions about your baby's growth and development.

At each well-baby visit, the doctor or nurse will check your baby's:

It's also recommended that your baby have developmental delay screening and a blood test for iron-deficiency anemia.

If the doctor is concerned that your child has been exposed to certain substances or diseases, tests may include:

For more information on important markers (milestones) of infant growth and development, see:

Screening, 13 Months to 12 Years

It's important for your child to continue to have regularly scheduled checkups, often called well-child visits. During these visits, your child's doctor will check your child's growth and development and examine your child for possible problems.

Checks at well-child visits include:

  • Behavioral and school concerns. Depending on the child's age, these may include temper tantrums, grades, relationship problems, and aggressive behavior that hurts others emotionally or physically (bullying).
  • Blood pressure . It is important for your child to have his or her blood pressure checked every year, beginning at age 3.
  • Hearing.
  • Vision.
  • Height, weight, and body mass index (BMI).

Regular dental checkups are recommended for all children once or twice a year.

Age-specific tests

Until your child is age 24 months, the doctor will measure the circumference of your child's head.

Until your child is age 5, the doctor will check for developmental problems, including two checks for autism. When your child is ages 10 through to 12, the doctor will check for scoliosis.

Other tests

Other tests may include:

For more information on the milestones of early childhood growth and development, see:

Screening, 13 to 18 Years

It's important for your teen to continue to have regularly scheduled checkups. At each well-child visit, the doctor will check your teen's growth and development and examine him or her for possible problems.

Checks at well-child visits include:

  • School and behavioral concerns, such as failing classes or dropping out of school, relationship problems with friends and family that affect home or school life, severe mood swings, lack of interest in normal activities and withdrawal from others, being physically aggressive, becoming sexually active, and using tobacco or drugs.
  • Blood pressure . It is important for your child to have his or her blood pressure checked every year. After age 21, he or she can follow the adult blood pressure screening guidelines.
  • Hearing.
  • Scoliosis.
  • Vision.
  • Height, weight, and body mass index (BMI).

Dental checkups are recommended for all teens once or twice a year.

Other tests

Other tests may include:

For more information on the milestones of teen growth and development, see:

Screening, Adult Women

Screening in adults is intended to identify diseases that may develop as you age. To help stay as healthy as possible, get routine checkups and have screenings that you and your doctor decide on.

How often women have the following tests depends on age, health, and things that make a specific disease more likely.

Tests that may be done include:

Women who are pregnant or trying to become pregnant may be screened for genetic conditions, gestational diabetes, sexually transmitted infections, and other conditions. For more information, see the topic Pregnancy.

Your age and tests

Some tests are only done at certain ages.

  • Experts recommend that all adults born from 1945 to 1965 get tested for hepatitis C.1, 2 People in this age group are more likely to have hepatitis C and not know it.
  • Before age 65, screening for osteoporosis isn't generally recommended. If you have risk factors, talk to your doctor about when to start screening.
  • For a screening checklist for women age 50 and older, see www.ahrq.gov/ppip/women50.htm.

Deciding about tests

It can be hard to decide whether you want to be screened for certain diseases or which type of test is best used. Combine medical information with your personal values to make a wise health decision.

Click here to view a Decision Point. Breast Cancer Screening: When Should I Start Having Mammograms?
Click here to view a Decision Point. Colon Cancer: Which Screening Test Should I Have?
Click here to view a Decision Point. HIV Testing: Should I Get Tested for Human Immunodeficiency Virus?
Click here to view a Decision Point. Osteoporosis: Should I Have a Dual-Energy X-Ray Absorptiometry (DXA) Test?
Click here to view a Decision Point. Pregnancy: Should I Have CVS (Chorionic Villus Sampling)?
Click here to view a Decision Point. STI Testing: Should I Get Tested for a Sexually Transmitted Infection?

Sometimes doctors automatically schedule routine tests because they think that's what patients expect. But sometimes research shows that testing may not be useful or worth the risks or costs. For more information, see Heart Tests: When Do You Need Them?

Screening, Adult Men

Screening in adults is intended to identify diseases that may develop as you age. To help stay as healthy as possible, get routine checkups and have screenings that you and your doctor decide on.

How often men have the following tests depends on age, health, and things that make getting a specific disease more likely.

Tests that may be done include:

Your age and tests

Some tests are only done at certain ages.

  • Experts recommend that all adults born from 1945 to 1965 get tested for hepatitis C.1, 2 People in this age group are more likely to have hepatitis C and not know it.
  • Before age 65, screening for abdominal aortic aneurysm isn't usually recommended. After age 65, talk to your doctor about your risk if you have ever smoked cigarettes.
  • Before age 65, screening for osteoporosis isn't generally recommended. If you have risk factors, talk to your doctor about when to start screening.
  • For a screening checklist for men age 50 and older, see www.ahrq.gov/ppip/men50.htm.

Deciding about tests

It can be hard to decide whether you want to be screened for certain diseases or which type of test is best used.

Click here to view a Decision Point. Abdominal Aortic Aneurysm: Should I Get a Screening Test?
Click here to view a Decision Point. Colon Cancer: Which Screening Test Should I Have?
Click here to view a Decision Point. HIV Testing: Should I Get Tested for Human Immunodeficiency Virus?
Click here to view a Decision Point. Osteoporosis: Should I Have a Dual-Energy X-Ray Absorptiometry (DXA) Test?
Click here to view a Decision Point. Prostate Cancer Screening: Should I Have a PSA Test?
Click here to view a Decision Point. STI Testing: Should I Get Tested for a Sexually Transmitted Infection?

Sometimes doctors automatically schedule routine tests because they think that's what patients expect. But sometimes research shows that testing may not be useful or worth the risks or costs. For more information, see Heart Tests: When Do You Need Them?

Other Places To Get Help

Organizations

Agency for Healthcare Research and Quality
540 Gaither Road
Suite 2000
Rockville, MD  20850
Phone: (301) 427-1104
Web Address: www.ahrq.gov
 

The Agency for Healthcare Research and Quality (AHRQ) is one agency within the U.S. Department of Health and Human Services. AHRQ supports research initiatives that seek to improve the quality of health care in America. AHRQ's mission is to improve the quality, safety, efficiency, effectiveness, and cost-effectiveness of health care for all Americans. The website provides evidence-based information to help people make decisions about health care services.



American Academy of Family Physicians: FamilyDoctor.org
P.O. Box 11210
Shawnee Mission, KS 66207-1210
Phone: 1-800-274-2237
Fax: (913) 906-6075
Web Address: www.familydoctor.org
 

The website FamilyDoctor.org is sponsored by the American Academy of Family Physicians. It offers information on adult and child health conditions and healthy living. There are topics on medicines, doctor visits, physical and mental health issues, parenting, and more.



American Academy of Pediatrics
141 Northwest Point Boulevard
Elk Grove Village, IL  60007-1098
Phone: (847) 434-4000
Fax: (847) 434-8000
Web Address: www.aap.org
 

The American Academy of Pediatrics (AAP) offers a variety of educational materials about parenting, general growth and development, immunizations, safety, disease prevention, and more. AAP guidelines for various conditions and links to other organizations are also available.



Centers for Disease Control and Prevention (CDC)
1600 Clifton Road
Atlanta, GA 30333
Phone: 1-800-CDC-INFO (1-800-232-4636)
TDD: 1-888-232-6348
Web Address: www.cdc.gov
 

The Centers for Disease Control and Prevention (CDC) is an agency of the U.S. Department of Health and Human Services. The CDC works with state and local health officials and the public to achieve better health for all people. The CDC creates the expertise, information, and tools that people and communities need to protect their health—by promoting health, preventing disease, injury, and disability, and being prepared for new health threats.



KidsHealth for Parents, Children, and Teens
Nemours Home Office
10140 Centurion Parkway
Jacksonville, FL 32256
Phone: (904) 697-4100
Web Address: www.kidshealth.org
 

This website is sponsored by the Nemours Foundation. It has a wide range of information about children's health—from allergies and diseases to normal growth and development (birth to adolescence). This website offers separate areas for kids, teens, and parents, each providing age-appropriate information that the child or parent can understand. You can sign up to get weekly emails about your area of interest.



References

Citations

  1. Smith BD, et al. (2012). Recommendations for the identification of chronic hepatitis C virus infection among persons born during 1945–1965. MMWR, 61(RR-4): 1–32. Available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6104a1.htm.
  2. U.S. Preventive Services Task Force (2013). Screening for Hepatitis C Virus Infection in Adults: Recommendation Statement. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspshepc.htm.

Other Works Consulted

  • Agency for Healthcare Research and Quality (2012). Guide to Clinical Preventive Services, 2012: Recommendations of the U.S. Preventive Services Task Force (AHRQ Publication No. 12-05154). Rockville, MD: Agency for Healthcare Research and Quality. Also available online: http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide.
  • American Academy of Pediatrics (2008). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 3rd ed. Elk Grove Village, IL: American Academy of Pediatrics.
  • American Academy of Pediatrics (2013). Ethical and policy issues in genetic testing and screening of children. Pediatrics, 131(3): 620–622.
  • Harrington S (2010). Screening. In CL Edelman, CL Mandle, eds., Health Promotion Throughout the Life Span, 7th ed., pp. 221–241. St. Louis, MO: Mosby.
  • Martin GJ (2012). Screening and prevention of disease. In DL Longo et al., eds., Harrison's Principles of Internal Medicine, 18th ed., vol. 1, pp. 29–33. New York: McGraw-Hill.
  • Tarini BA (2007). The current revolution in newborn screening. Archives of Pediatric and Adolescent Medicine, 161(8): 767–772.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer John Pope, MD - Pediatrics
Last Revised July 25, 2013

Last Revised: July 25, 2013

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