When (and which) can we stop doing screening tests?

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I am often asked ” Do I still need. . . . mammograms? pap smears? prostate screening?” These are good questions. this depends on the patient’s current quality of life and life expectancy.
Female cancers that are routinely screened for include cervical, colon, and breast. Men’s screenings focus on prostate and colon cancers.
Pap smears.

  • This reveals abnormal cells on the cervix. If a woman had her uterus removed for reasons other than cervical dysplasia (abnormality of cells on the cervix) or cervical cancer, a Pap smear is no longer needed.
  • If a woman still has a uterus and has no history of abnormal Pap smears, then the last pap would be at age 65.

Ovarian cancer

  • A bimanual exam (which I refer to the exam with two fingers inside the vagina and one hand on top of the abdomen) is best done every year. This helps to screen for ovarian cancer.

Breast cancer

  • A breast exam should also be done every year, as part of a well-woman examination. Therefore, it is still important for elderly women to visit their physician yearly for a “well woman exam.”
  • Mammograms should be discontinued at age 75, or when life expectancy is less than 10 years.

Colon Cancer

  • Men and women should be screened for colon cancer until there is a 10 year life expectancy left.
  • There are several ways to look for colon cancer: colonoscopies, barium studies in the x-ray department, stool specimens to look for blood, or CT scan testing.

Prostate cancer.

  • This is a controversial issue. One of every six men will develop prostate cancer during their lifetime, yet only about 3% of men die FROM it.
  • The United States Preventative Service Task Force echoes this practice and states that there is insufficient evidence to recommend for or against screening for prostate cancer.
  • However, you and your physician can decide what is in your best interest.

Bone density screening.

  • Osteoporosis (low bone density) is seen in about 7% of women.
  • Recommendations are to check every woman after age 65, or five years after menopause in women with risk factors.
  • Osteoporosis is not only a disease for women, as it does affect some men.

High cholesterol.

  • Screening should begin based on family history, but at least by age 45 for women and age 35 for men.
  • Screening should begin at a younger age if risk factors are identified.
  • Cholesterol screening can continue at intervals of every 3 to 5 years.
  • If no elevated cholesterol found by age 65, cholesterol screening tests can be stopped as it is unlikely to start after this age.

As always, individual health maintenance and preventive care are best discussed with your physician so that your care can be customized based on your risk factors, family and personal history.

Want more information? American Cancer Society at http://www.americancancer.org and The American Heart Association at http://www.heart.org

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About drlesliegreenberg

I have been practicing as a family physician for over 20 years--as both an educator of physicians and clinician. From infancy to the elderly, I perform obstetrics and general medicine. I love my career and am passionate about my field of knowledge and my patients. Follow me on Facebook at Leslie Md Greenberg Medical Disclaimer The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.
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