As we push into our 50s and beyond, routine screenings to detect health problems become more and more important. Often, the earlier a problem is detected and diagnosed, the earlier it can be successfully treated or managed. Screenings are a critical part of protecting our health. But which tests do we really need, and when? And how do we weigh their benefits against any risks?
The following screenings are recommended for people age 50 and older on a routine basis — that is, for people without symptoms or special risk factors for a given disease. The list is based on guidelines from the U.S. Preventive Services Task Force, a panel of experts in prevention and medicine that, after careful review of scientific findings, issues advice meant to guide medical care broadly, but not to determine individual cases.
Under health care reform law, people in original Medicare will receive free preventive screenings starting next January, and most Medicare Advantage plans already offer this benefit. Most of these screenings also are free for those getting new health insurance policies this year, after Sept. 23.
Prostate cancer: PSA
The test: a blood test known as the prostate-specific antigen test or PSA.
The guidelines: The task force recommends against the PSA screening in men age 75 and older, and concludes there is not enough information to recommend for or against the test in younger men. The American Urological Association says the test should be offered to "well-informed men who wish to pursue early diagnosis," starting at age 40 and as long as a man's life expectancy is at least 10 years.
What to consider: Autopsy studies have shown that roughly one in three men over age 50 has cancer in the prostate gland. Clearly many of these prostate cancers would never cause a problem or be discovered without screening. But if a cancer is detected through a PSA test and follow-up biopsy, it's not easy to tell how dangerous it is, and the momentum carries most patients into aggressive treatments like surgery, radiation or hormone therapy, whose common side effects are impotence and incontinence.
Last year, results from a large European trial showed a 20 percent reduction in prostate cancer deaths among men screened for the disease. This benefit (which was not confirmed by a U.S. trial published at the same time) came at a high price: For every life saved in the decade after screening, the investigators concluded, 48 men were subjected to needless treatment for prostate cancers that would not have harmed them.
Next: Mammogram. »