Health Care Screening

Screening Program

Screening visits ages 20-40 for at least every 2 years. Over 40, every year

History Complete

Initial visit only (yearly in selected patients)
System Review:
Including diet and exercise, smoking and alcohol use, noise or pollutant exposures
Each Screening Visit

 

Physical Exam Procedures

CompleteInitial visit and yearly in selected patients
WeightEach screening visit
Blood Pressure, Pulse and RespirationEach screening visit
Eye ExamEach screening visit (selected patients)
Hearing ExamEach screening visit (selected patients)
Skin Exam Each screening visit
Breast ExamEach screening visit
Pelvic Exam (by Internist or Gynecologist)Each screening visit – age over 50
Rectal Exam (check stools for blood)Each screening visit – Age over 40
Tonometry (Glaucoma check) Each Screening Visit – age over 40 every 2 years (dependent on risk)
Dental ExamEach Screening Visit
Proctoscopy(Flexible Sigmoidoscopy/Colonoscopy/CT Colongraphy) – Every 10 years after age 40-50 (more often in selected patients)
 

Lab Tests

Pap SmearEvery 2-3 years (after 2 negatives, 1 year apart) (up to age 65-70 after 3 negative exams)
Stool for Occult BloodEach screening visit over age 40
Complete Blood Count (CBC)Every Screening Visit
Chemistry Screening(includes Urinalysis, Cholesterol-lipid screen, Electrolytes, Kidney function, Liver function, Calcium and Phosphorous, Uric Acid, Blood Sugar)
Thyroid Profile (TSH)Every 2-4 years over 40
PSA Every year (Selected Males age 50 to 70)
TB Skin Test (PPD) – High Risk Groups
HIV, RPRHigh Risk Groups
Hepatitis C AntibodyHigh Risk Groups
EKG, Cardiac Echo
(CT Scan/Calcium Score) Baseline at age 50 (Selected Patients)
Exercise EKG (Treadmill Stress Test)
(Myocardial Perfusion Scan/Echo) High Risk Groups
Bone Density (DEXA) – High Risk Groups, Baseline at age 50-60 (Females, Selected Patients) (Baseline at age 70 (Males)
Carotid/Abdominal UltrasoundSelected High Risk Groups
 

 

Teach

Breast, Testes Self-ExamInitial screening visit
Use Sun Screen and Avoid SunEach screening visit
 

 

Immunizations

InfluenzaEvery year

DPT (Diptheria, Pertussis, Tetanus) – Every 10 years

Pneumococcal VaccineOver age 60 or high risk groups (every 5-10 years)

Measles, Mumps, Rubella – Full course if non-immunized

Zostavax (Shingles) – Over age 50-60 in patients with a history of Chicken Pox

Hepatitis A and B – High Risk Groups/Travel

Typhoid, Yellow Fever – Highly Selected Groups – Travel
 

 

American Cancer Society Recommends

(1) Women 20 and over, and those under 20 who are sexually active, should have a PAP Test at least every 3 years, after 2 initial negative tests a year apart.

(2) Women 20 – 40 should have a pelvic examination as part of a general physical examination every year and women over 40 every 1 – 3 years. (after menopause every 1 – 5 years)

(3) Every woman should have a pelvic examination and PAP test at menopause. Those at high risk of endometrial cancer should also have an endometrial tissue sample examined. High risk is defined as having a history of infertility, obesity, failure of ovulation, abnormal uterine bleeding, or estrogen therapy.

(4) Women over 40 should have a mammogram every year. Women under 40 should consult their personal physicians about the need for mammography in their individual cases. All women should have a breast baseline mammogram between the ages of 35 – 40.

(5) Women 20 – 40 should have a breast physical examination every three years, and women over 40 should have a breast physical examination every year.

(6) All women over 20 should perform a breast self-examination monthly.

(7) Men and women over 20 should have a stool gualac slide (test for occult blood) every year.

(8) Men and women over 40 should have a sigmoldoscopic examination every five to ten years. (colonoscopy screening in selected patients)

(9) Men and women over 40 should have a digital rectal examination every year.

(10) Selected men over age 50 should have a PSA in addition to a digital prostate exam.

(11) Men and Women over age 20 should have a full body exam annually – selected men and women.

(12) The role of CT screening for cancer is not yet defined