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Catching Medical Issues Early Makes Them More Treatable

If you haven’t scheduled a primary care visit in more than a year, now’s a good time to do so. During the COVID-19 pandemic, many people delayed routine doctors’ exams and cancer screenings. Missing routine visits and screenings can mean cancer and other illnesses aren’t caught until they have progressed. This makes it more difficult to successfully treat them, according to Noble Jacob, MD, a board-certified family medicine physician with Highland Medical, P.C., Orangetown Family Practice in Tappan, NY. 

“Many patients, especially older ones, have missed exams, and as a result, their condition worsened, or a diagnosis was missed during the pandemic,” said Dr. Jacob, a native of Rockland County who has been practicing medicine in his hometown for the past eight years.  “Routine checkups and screenings can reduce the risk of illness, disability and death. Getting regular checkups and screenings can also uncover health conditions that can place you at risk for complications from infections like COVID or pneumonia.” 

The Annual Exam: What to Expect
At your annual exam, your doctor will talk with you about ways you can improve your health, such as losing weight and managing your medical conditions. “It’s so important to address obesity,” he said. “Being at a healthy weight is important in helping to prevent infection, heart disease and diabetes. It can extend your life.” He noted that the majority of patients who have been hospitalized or died from COVID-19 were overweight or obese.

Your exam will also include:

  • A full body examination
  • Blood pressure check
  • Blood tests to check for diabetes, measure your cholesterol and other tests based on your evaluation

Doctors generally decide which patients should receive which screening tests based on recommendations from the U.S. Preventive Services Task Force. This is a group of national experts in prevention and evidence-based medicine.

Common screening tests look for:

Depression. The task force recommends screening for depression in all adults. “Screening for depression substantially reduces suicide rates and drug and alcohol abuse,” Dr. Jacob said.

Colon cancer. The task force recommends that everyone starting at age 50 undergo periodic colon cancer screening. “A colonoscopy is considered the gold standard for colon cancer screening,” Dr. Jacob said. “But there is now an alternative, which is less accurate but some patients prefer it.” The newer test, called Cologuard, allows patients to take a stool sample at home and mail it for testing. “If the sample indicates the person has a predisposition to colon cancer or has blood in their stool, then further testing is needed,” he said.

Fall risk and dementia. All patients over 65 should be screened for their risk of falling. They also should be screened for dementia. “The doctor can often discover signs of dementia earlier than the family can,” he said.

For women, the task force recommends:

  • Cervical cancer screening starting at age 21. This includes a Pap test and human papillomavirus (HPV) test. Based on the results, the doctor will recommend how often a woman should get these tests. Many women can wait three to five years between testing.
  • Breast cancer screening with a mammogram (and possibly ultrasound) should start at age 40 in women with no family history of breast cancer. For women with no abnormal results, screening should continue every one to two years. For women with a family history of the disease, screening should start earlier.
  • Bone density testing for women should start at age 65 to detect osteoporosis “Those with weakened bones tend to have fractures when they fall,” Dr. Jacob said. They also tend to have arthritis, or worsening arthritis. It’s important to find osteoporosis early and address it to help strengthen bones.”

For men, the task force recommends:

  • Men between ages 55 and 69 should talk with their doctor about the benefits and potential harms of blood tests to screen for prostate cancer.

“Our bodies are constantly changing. Routine checkups can catch things that may not be causing symptoms yet,” Dr. Jacob said. “That’s why it’s so important to come in for a yearly exam.”