We all worry about our health as we get older, but routine checks and screenings can provide reassurance and help catch any worrying conditions at an early stage. So, what are the essential checks for the older subject?
The NHS offers a health check every five years to everyone aged between 40 and 74, looking particularly for signs of stroke risk, diabetes, dementia and heart and kidney disease. The British Heart Foundation estimates that seven million UK citizens have undiagnosed high blood pressure, increasing the risk of heart disease or a stroke.
See Also: Your Key Health Checks
There are national screening programmes for early detection of cervical, breast and bowel cancer, and aortic aneurysms, as well as checks on ovaries and breasts for women, and testes and prostate for men.
Indeed you could go in for a ‘whole body scan’, though some clinicians don’t encourage the idea, suggesting that it could trigger a cascade of surgical investigations of minor abnormalities resulting in little overall improvement in health levels—so ultimately universal whole body scans might do more harm than good.
Dr Margaret McCartney, a GP who presented a BBC radio documentary on screening, says: “If a screening test is cost-effective, the NHS is doing it. We don’t have evidence for additional tests at the moment.”
So, what are the most effective and worthwhile tests available on the NHS?
Abdominal aortic aneurysm (AAA) screening
AAA screening checks for a bulge or swelling in the aorta, the heart’s largest artery. An abdominal aortic aneurysm won’t often have symptoms, but if it enlarges and bursts it could cause life-threatening bleeds inside the stomach. Aortic aneurysms are more common in men, so they are offered screening at the age of 65. Ultrasound tests take only a few minutes, are painless and give immediate results.
Blood pressure screening
High blood pressure can weaken the heart and damage arterial walls. Testing with a pressure cuff can be done by a practice nurse, is quick and painless and gives immediate results. You may also be offered a kidney function blood test.
Bowel cancer screening
Bowel cancer is the fourth most common cancer in the UK and the sooner it is detected, the easier it is to treat and the better your chance of surviving it. Bowel cancer screening is indicative rather than conclusive but can detect potential problems. It’s done using a Faecal Occult Blood Test (FOBt) card which is used at home then sent to a lab for analysis. Screening is offered every two years to all men and women aged 60 to 74. A colonoscopy will be required for full diagnosis.
There has been recent discussion about mass breast screening picking up on asymptomatic cancers which would not require treatment, but it’s largely accepted that regular breast screening is beneficial. From the age of 47 (older in some areas) to 71 all women should be invited for an X-ray mammogram every three years. The procedure can be uncomfortable but takes only a short time. Results are returned in about two weeks, followed by an invitation to an assessment clinic if necessary.
About 3,000 cases of cervical cancer are diagnosed each year in the UK, but since the screening programme was introduced in the 1980s, the number of cervical cancer cases has decreased by about seven percent each year. All women aged 25-64 are eligible for a free cervical screening test every 3-5 years. A cervical examination using a speculum can be uncomfortable but doesn’t take long. Test results and if necessary an invitation for further examination are usually received within two weeks.
High levels of the fatty substance cholesterol in the blood can cause no symptoms but can increase the risk of a heart attack or stroke. Cholesterol testing involves a simple blood test. Treatment includes changes to lifestyle such as diet and exercise, and if necessary, your GP may prescribe cholesterol-lowering medicines such as statins.
The NHS Health Check
This is the big one! The NHS Health Check is a free check-up of your overall health and can suggest whether you are at risk of common health problems such as heart disease, diabetes, kidney disease and stroke. It takes 20-30 minutes and involves a range of checks including height, weight, blood pressure, blood tests and a questionnaire about lifestyle and family history. If you’re over 65, you will also be told the signs and symptoms of dementia to look out for. You should be invited for a free NHS Health Check every five years if you’re between 40 and 74. If you haven’t had an NHS Health Check in the last five years, ask your GP for an appointment now.
This feature was originally published in the winter edition of Live to 100 with Dr Hilary Jones, which you can read here