Preventive medicine is the best medicine. When we catch something early, we are better able to stop it in its tracks or at least start treatments to decrease the risk for complications. That said, if your primary care provider performed every screening test available, you would never leave the office.

What Screening Tests Do You Need?

The United States Preventive Screening Task Force reviews pros and cons of different preventive screening tests. Will screening be helpful? Have interventions for the condition proven to be beneficial? Will they make a difference in your life?

You may be surprised to learn what screening tests the government does not want you to have. Some of their recommendations may leave you scratching your head.

1 — Breast cancer screening

While the USPSTF recommends mammograms for breast cancer screening every other year from 50 – 74 years old, they do not want doctors teaching you how to do a self-breast exam. They take it a step further and state there is not enough evidence to recommend that your DOCTOR examines your breasts during your physical.

How many women would not have gotten their mammogram had they not felt a lump in their breast?

2 — COPD screening

The USPSTF advises against screening for chronic obstructive pulmonary diseases (COPD), like chronic bronchitis and emphysema, even if you have a history of smoking. This is the case even though more than 25 percent of smokers will develop COPD over their lifetime. Specifically, they recommend not screening with pulmonary function test or spirometry unless you have a persistent cough, increased sputum production, wheezing or shortness of breath.

How many smokers could have had their lung disease delayed by early intervention?

3 — Osteoporosis screening in men

The USPSTF acknowledges that 20% of men will suffer from an osteoporotic fracture in their lifetime. The statistics become grim when you see that 1 in 5 people will die within a year of breaking their hip. Despite this, they say there is not enough evidence to recommend bone density screening for osteoporosis in men.

How will you feel about a life-threatening hip fracture that could have been prevented if you didn’t have a Y chromosome?

4 — Prostate cancer screening

The USPSTF advises against screening for prostate cancer with the prostate-specific antigen (PSA) blood test. They claim that while PSA helps to detect aggressive cancers, it may also detect cancers that would not have caused clinical symptoms. Treatment of these cancers could lead to unnecessary side effects.

How will a man’s aggressive prostate cancer be detected early?

5 — Screening for abuse in the elderly

As many as 10% of seniors are abused every year. This may be physical or verbal abuse. It can also be neglect or exploitation. Since not enough studies have been done on the subject, the USPSTF says there is not enough data to recommend screening.

How would you feel if your grandmother were being abused and no one stepped in?

6 — Screening for cognitive impairment

More than 40 million Americans have dementia and the number is rising. This can decrease someone’s ability to perform day to day activities and can also risk their safety. Despite this, the USPSTF does not recommend screening stating there is not enough data to support it.

What if your parent or grandparent were suffering from memory loss and a screening test could have detected it?

7 — Screening for hearing loss

More than 30 percent of Americans over 65 years old have some degree of hearing loss. The USPSTF says there is not enough evidence to recommend screening for hearing loss in adults over age 50 unless they report symptoms.

How many seniors ignore or try to adapt to their symptoms before they report them? Does decreased hearing increase their risk, i.e. with driving?

8 — Screening for vision impairment

Nearly 27 million Americans experienced vision loss in 2017 with 7.8 million adults over 65 years of age reporting significant impairments. Vision problems also contribute to falls and injuries in the elderly. Despite this, the USPSTF states there is not enough to screen for vision impairment in older adults.

How many falls and injuries are attributable to vision problems in the elderly each year?

Even though the USPSTF may recommend against them, it does not mean your doctor will not pursue these screening tests or that your insurance won’t pay for them. Do not hesitate to reach out to your doctor with questions.

 

Facts and Figures on Adults with Vision Loss. (2020). American Federation for the Blind. https://www.afb.org/research-and-initiatives/statistics/adults

Hip fractures among older adults. Centers for Disease Control and Prevention. http://www.cdc.gov/homeandrecreationalsafety/falls/adulthipfx.html

Lokke A, Lange P, Scharling H, Fabricius P, Vestbo J. Developing COPD: a 25 year follow-up study of the general population. Thorax. 2006 Nov; 61(11): 935–939. https://doi.org/10.1136/thx.2006.062802

United States Preventive Services Taskforce. (2023). Uspreventiveservicestaskforce.org. https://www.uspreventiveservicestaskforce.org/uspstf/