We've seen a lot of medical breakthroughs in the past century, but one of the most remarkable things we've witnessed is the change in our thinking. We've become more proactive about our health, and we're aiming to catch diseases early on -- if we can't prevent them altogether.
However, some health issues aren't easy to detect in their early stages, and we may not be aware of our risks. Here are some key tests and measures to keep up with:
Body Mass Index (BMI)
Experts constantly remind us that we should watch our weight, but the number on the scale is only part of the picture. The BMI gives you a better indication of how your weight will affect your health by factoring in your height as well.
Curious about your number? Try Health Canada's Body Mass Index (BMI) Nomogram. If your BMI is in the 18.5 - 24.9 range you're at the lowest risk for developing health problems. People with a BMI between 25 and 29.9 are considered overweight, while people with a BMI over 30 are classified as obese. Essentially, a number over 25 is a warning sign for health problems where weight is a contributing factor.
A word of caution: this scale is meant for people between the ages of 18 and 65 (with the exception of those who are very muscular, pregnant or breastfeeding). If you're over 65, the "normal" range is actually a little higher -- so don't panic if your BMI ventures above 25.
The fat stored around the mid-section -- where the vital organs are -- puts people at risk for high blood pressure, high blood cholesterol, type-2 diabetes, heart disease and stroke. The Heart and Stroke Foundation therefore advocates getting out that measuring tape and finding out your waist circumference in addition to knowing your weight and BMI.
What results should you worry about? The cut-off numbers depend on ethnicity and gender. Men who are of European/Caucasian, Sub-Saharan African, Eastern Mediterranean or Middle Eastern descent should have a waist circumference below 102 cm (40 inches). Men who are of Asian, Indian and Ethnic South and Central American descent should aim a little lower for 90 cm (35 inches). For women, the numbers are 88 cm (35 inches) and 80 cm (32 inches) respectively. (Again, these numbers apply to people between the ages of 18 - 65 and those who aren't pregnant or breastfeeding.)
If your number is a little high, take heart: losing as little as five per cent of your weight can reduce your risk. (See the Heart and Stroke Foundation's Healthy Waists website for details.)
Heart health has been making the news a lot lately due to recent celebrity deaths, but how many of us actually know our risks? According to Dr. Akbar Panju, Division Director of General Internal Medicine at McMaster University, 80 per cent of us have at least one risk factor for heart disease and stroke. Forty-one per cent have two risk factors -- and 10 per cent have three. (See Risky Business for details).
Some factors we can't control, like gender, age, ethnicity and family history. However, risk factors like diet, exercise, weight, smoking and stress are lifestyle choices -- meaning we can (and should) do something about them.
Do you know your risks? Try the Heart and Stroke Foundation's Heart & Stroke Risk Assessment ™ -- it will walk you through all the risk factors. If you want to know your risks over the next ten years, try the Reynolds Risk Score calculator.
Blood pressure checks
One in five Canadians has high blood pressure (also known as hypertension), but 42 per cent of them don't know it, according to the Heart and Stroke Foundation. It's the number one risk factor for cardiovascular disease, but with proper treatment you can reduce your risk of stroke by up to 40 per cent and your risk of heart attack by up to 25 per cent.
How often should you get a checkup from a health care professional? At least once every two years after the age of 20. (Make that once a year if you already have hypertension.) Normal or optimal blood pressure should score below 120/80 mm Hg, and blood pressure over 140/90 mm Hg is considered high (130/80 for diabetics). Anything in between is considered borderline and still warrants attention.
(Click here for more information.)
Another major risk factor that's hard to see is high cholesterol. In high levels, low-density lipoprotein (LDL) cholesterol can encourage plaque buildup in the artery wall -- which in turn leads to narrow arteries, heart disease, stroke and circulatory problems.
When should you start worrying about cholesterol tests? In general, the Heart and Stroke Foundation recommends regular checks for men over 40 and women over 50 (or women who are post-menopausal). People who have heart disease, diabetes and high blood pressure, or who have had a stroke, should also be checked, as should people who have known risk factors like a high waist circumference or a family history of cardiovascular disease.
An ideal result for LDL would be less than 100 milligrams per deciliter of blood, but a result between 100 - 129 mg/dl is considered normal. An LDL of 160 mg/dl is considered high -- and where most doctors will start recommending medication.
For more information on the types of cholesterol and what test results mean, download the Living with Cholesterol brochure (PDF file).
Bone mineral density (BMD)
According to Osteoporosis Canada, an estimated one in four women and one in eight men over the age of 50 has osteoporosis. Early detection and treatment is critical to treat this "silent thief" and to prevent disabling bone fractures. An assessment of your risk factors and a BMD test can help alert your doctor to potential problems.
So when should you start screening? Osteoporosis Canada recommends that all postmenopausal women and men over the age of 50 should be assessed for major risk factors (like certain medical conditions, family history, previous fractures, etc). A BMD test is in order if you're over the age of 65 or have been identified as high-risk. (For more information, visit the Osteoporosis Canada website.)
You might be living with type-2 diabetes and not know it. However, with proper treatment you can avoid complications like heart disease, kidney disease, eye disease, nerve damage and impotence.
There are actually a variety of tests to detect diabetes or pre-diabetes: glycated hemoglobin (A1C) test, fasting blood glucose (FPG), casual blood glucose and oral glucose tolerance. The Canadian Diabetes Association recommends that you should be tested at least once every three years if you're over the age of 40. If you're in a high risk group or have a family member with type-2 diabetes, you should be tested earlier and checked more often.
At-home cancer checks
You didn't think health care professionals were going to do all the work, did you? There are some cancer checks we can do at home to spot early signs of certain types:
Breasts: It's not a definitive diagnostic test, but women and their partners are the ones who usually find lumps or changes in the breast. That's why doctors still recommend breast self-examinations (BSE). The best time to check is 5 to 10 days after your period starts, or if you no longer have a period simply pick a regular day of the month. (For more information and a how-to, see Breastselfexam.ca.)
Testicles: As with breast cancer, regular testicular self-examination can help find lumps and changes that a doctor should look at. (Mayoclinic.com explains how to do it properly.)
Skin: Keep an eye on those moles, and watch out for any suspicious sores. (WebMD has a slide show of things to watch out for.) As with breast and testicle checks, the important thing is to know what's normal for you versus what has changed.
Colorectal: Screening for this common cancer starts well before the symptoms do. The Canadian Cancer Society recommends a fecal occult blood test (FOBT) every two years for people over the age of 50. This at-home test detects blood in stool that you can't see. If the test results are positive, your doctor will order follow-up tests like a colonoscopy. (Click here for more information.)
Good news: Statistics Canada recently reported that more Canadians are getting preventative tests than in the past. Here's what to make sure you include:
Women: While they're not the more pleasant of procedures, Pap tests and mammograms are recommended for regular screening. Though guidelines differ by province, in general women should get a Pap test every one to three years after becoming sexually active -- even women who have had hysterectomies.
For breast cancer, current guidelines recommend that all women over the age of 40 get a clinical breast examination once every two years. However, unless there are risks or a family history, women can wait until age 50 to start getting mammograms (every two years is ideal). At age 70, a woman and her doctor can decide what further screening is needed.
Men: Digital rectal examinations are part of a physical exam, but many men aren't sure whether they need a prostate-specific antigen (PSA) test or not. There's some controversy because researchers are still investigating how effective they are at saving lives. Currently, there is no proven screening method for prostate cancer, so men should talk to their doctors if they're concerned.
For more information about cancer screening, visit the Canadian Cancer Society.
Tests for known risks
Here's where it gets personal: is there a family history of a particular disease, or a past or present vice that could put you at risk? If so, it's time to talk to your doctor about issues like:
- Cancer, heart disease, autoimmune disorders and other conditions present in your family. You may need to have your risks assessed, or be tested at a younger age.
- Sexually transmitted illnesses (if you've had unprotected sex). Don't let age fool you -- HIV, chlamydia and gonorrhea are showing up in older adults too.
- Smokers and former smokers should be on the lookout for conditions like chronic obstructive pulmonary disease (COPD), lung cancer and aortic aneurysms.
Overall, your best course of action is to keep up with your regular physical examinations and talk to your doctor about any concerns you might have.
Additional sources: Health Canada, Public Health Agency of Canada, Forbes.com Eight life-saving tests
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