Your Basic Health Maintenance Plan

Cholesterol, Women's Health and Bones

Cholesterol check: The timing of this screening test is debatable. What's not debatable is that heart disease is the No. 1 killer of men and women in our country. The National Cholesterol Education Program recommends that cholesterol be checked at age 20, then every five years after that as long as your cholesterol is in the normal range. If it's elevated, your physician will test your triglycerides (another type of fat in the blood), LDL (bad cholesterol) and HDL (the good guy). Your follow-up cholesterol tests will be adjusted as needed, depending upon the treatment plan (diet, exercise, medication) and its results.

C-Reactive Protein (CRP): This may be one blood test you haven't heard of, but according to the American Heart Association, CRP has become a powerful new predictor of cardiovascular risk. Researchers have found that you can still be at risk for heart disease if your CRP is high and your cholesterol levels are normal. The good news is that CRP can be treated with the medications we use to treat high cholesterol, namely, the "statin" drugs, or niacin. This test may become widely used over the next several years.

Women's Health

Mammogram: This procedure's ability to detect breast cancer is controversial. I recommend a baseline mammogram at age 40, then yearly after that. If you have a family history of breast cancer, I'd recommend a mammogram at age 35, especially since breast cancer is inherited about five to 10 percent of the time.

Remember to do a monthly breast self-exam beginning at age 20 and have a physician perform this exam at least once every two to three years when you are in your 20s and 30s, and yearly after age 40.

Numerous studies have shown that an annual mammogram combined with a breast exam by a healthcare practitioner cuts a woman's risk of dying from breast cancer by more than a third. If you ever notice a change in your breasts, please don't hesitate to visit your healthcare professional. Even if your mammogram is normal, but you feel something isn't right, talk to your doctor.

Pap Smear and Pelvic Exam:

For women 18 and over, this should be done yearly. If you're sexually active at a younger age, these exams should start then. The Pap smear has reduced deaths from cervical cancer by more than 50 percent since it was introduced in the 1940s. Make sure your physician uses a lab that meets the standards set by the College of American Pathologists, and also ask if the Pap smears are rechecked by the new computerized methods, or by using the thinprep technique. Some of these newer methods enable the lab to give more accurate results. If you've reached menopause, it's still important to get both tests.

Healthy Bones

Bone Density: This important screening test for osteoporosis (thinning and weakening of the bone) can detect low-bone density before the bones weaken and fracture. Some 28 million Americans are at risk for osteoporosis, while 10 million of them have the disease (80 percent are women).

In spite of this huge number, the National Osteoporosis Foundation estimates that only 29 percent of U.S. women with osteoporosis are diagnosed, even though osteoporosis is the major cause of at least 90 percent of all hip and spine fractures in older women. It's recommended that women speak with their physicians about bone-mineral-density testing and that they receive a bone-density test by age 65 - at the latest.

Younger women who are very thin, smoke, drink excess alcohol, or who have a bone fracture after age 40 or a family history of osteoporosis, may need to have a bone-mineral-density test at age 50, or earlier. The results of the test will help determine whether medications are needed to halt the progression of osteoporosis.


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