The purpose of health screening (that is, going for a health checkup when you feel quite well) is to identify health risks or diagnose illness before it becomes apparent, thus hopefully catching it early enough to cure it or to prevent progression. The most important factor in reducing suffering from illness at any age is early detection and treatment.
Screening has its limitations. It can’t anticipate all health risks or pick up every disease before symptoms appear (for example tumours deep inside the body that are too small to be felt or that don’t show up on the usual screening tests). However, screening can discover the most common health problems of older people. Routine health screening includes the following.
General physical examination
A thorough physical entails:
a inspection of the skin to look for precancerous changes that can be removed
b counting the pulse and listening to the heart sounds
с examining the pulses in and condition of the legs and feet to detect any problems with circulation to the lower limbs
d listening to the breath sounds
e feeling for enlarged lymph glands in the neck, armpits and groin, and feeling the thyroid gland in the neck
f inspection of the mouth and throat
g feeling the abdomen for any enlarged organs or other swellings
h breast and pelvic examination for women, and Pap smear every two years until the age of 70
j examining the retina (the lining of the back of the eye).
Blood-pressure measurement
If raised blood pressure – which rarely causes any symptoms – is reduced by treatment (often simply weight reduction and exercise, sometimes medication) the risk of later stroke is greatly reduced or prevented.
Urine testing
Testing for sugar is very important. About half of all cases of late onset diabetes remain undetected, because this disease may cause no symptoms until complications have developed. If diabetes is suspected on urine testing and confirmed by blood tests, early treatment can prevent or reduce serious complications and there is a greater possibility that blood sugar can then be controlled by diet alone.
Finding blood or protein in the urine may suggest other disorders of the urinary system.
If you are past the menopause and not using HRT, your doctor will suggest using oestrogen-containing pessaries in the vagina for a week before taking your smear. Results can be misleading if a Pap is taken when the epithelium covering the cervix is affected by lack of oestrogen. This sounds like a lot, but these routine screening procedures take only about 20 minutes.
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