I am routinely asked by my patients what new medical advances will greatly improve their health. With the news, media and internet we are bombarded with new and exciting medical breakthroughs that are touted as the wave of the future. The reality is that these new technologies don't always pan out and what has been tried and true still has the most impact on your health. Below I am going to discuss the 'top ten' prevention priorities for your health in 2010. These 'top ten' will have the most impact on your immediate health in regards to morbidity and mortality (i.e.-increase your quality of life and life expectancy). You will be surprised what makes the list and what doesn't. After reading them you will see that none of them are high-tech or expensive.
#1&2- Heart Disease Prevention and Smoking.
Heart disease is the single biggest killer in our country, one out of five persons living in our country will die from heart disease and many more will have some heart related complications. The single biggest player in this is smoking. If you add up all the health benefits from all other health screening recommendations (i.e.-mammograms, cholesterol checks, colonoscopies, blood pressure checks, ect . . .)
they do not equal the benefit to your health if you quit smoking. The next biggest 'bang for your buck' in heart disease prevention is aspirin. If you are a male over 55 years old or a high risk patient, your risk for a heart attack can be decreased 25% just by taking a baby aspirin daily. It's amazing that a 3 cent pill can be more effective that any of the newer medications that we hear about daily. Blood pressure control, cholesterol control, weight loss, ect . . . are other important factors in consider in reducing your risk for heart disease.
#3-Colorectal Cancer Screening.
Colon cancer is the 3rd most common cancer killer in the U.S. It can be treated easily and early with a simple colonoscopy. The current recommendations are to begin screening in the general population at 50. If you have a family history of polyps or colorectal cancer you should begin sooner. How soon depends on the age and relation of your family members. You should discuss this with your doctor.
It's amazing that the 4th most effective preventative health screening tool is a simple blood pressure check. If you develop high blood pressure and it is detected early and treated, you can literally add years to your life and prevent the many complications of high blood pressure. The problem with high blood pressure is that most people feel fine when they have it and so don't feel they need to treat it until their 1st event (i.e.-heart attack, stroke) but treating early makes a huge difference. The current recommendation is to screen for high blood pressure every two years.
It interesting that one of the top preventative health innovations in the last two centuries (the other being antibiotics) would cause so much controversy. Currently for the appropriate patients the American College of Immunization Practices recommends an annual flu shot and a pneumonia vaccine at age 65. Over 30,000 people die annually from influenza and its complications and 70% of invasive pneumonia can be prevented by the Pneumovax. There are other vaccines for adults but these two have the most evidence for disease prevention in this age range.
#6- Alcohol Screening and Counseling.
About 75,000 people die annually from Alcohol related events. These include liver disease, accidents, abuse, suicide and drowning. Screening for alcohol abuse with four simple questions (CAGE questionnaire) in the doctor's office can detect most people who abuse alcohol and interventions have been shown to decrease the morbidity associated with it.
#7- Vision Screening.
This is recommended for patients 65 years or older. Five percent of this population are blind and 50% have vision problems. Decreased visual acuity is associated with a high risk of falling, motor vehicle accidents and accidents with mediations. This can be easily evaluated in your doctor's office using a Snellen Chart.
#8- Cervical Cancer Screening.
Since the implementation of the PAP smear in the 1960's, the incidence of death from cervical cancer has decreased 10 fold. In the 1960's cervical cancer was the most common cause of death in middle age women, it is still a common cause of death in the rest of the world. This disease can be detected during a routine gynecologic exam in your doctor's office. The current recommendation for 2010 is to start screening at age 21 or three years after the start of sexual activity and to continue screening every two years.
#9- Cholesterol Screening.
The best current evidence suggests that cholesterol screening is most effective in the age ranges of >34 for men and >44 for women. If caught earlier, dietary and lifestyle modification are usually the 1st line of treatment but after the above ages you should be screened with the intent to treat if you are found to have an elevated cholesterol.
#10- Breast and Colon Cancer Screening.
Breast cancer is the 2nd most common cancer in women (behind lung cancer) and colon cancer is the 3rd most common cancer in both men and women. Both can be easily detected and treated if caught early. Colon cancer screening starts at 50 years old for men and women unless you have additional risk factors. Breast cancer screening in the U.S. starts at age 40. For more information about breast cancer screening please see my last post about it.
So there you have it. If you have any questions about the above or haven't had them done, call you doctor to schedule a routine physical. During this exam the above can be addressed and scheduled