Preventive health: What every woman should know

Preventative healthcare could save your life, get yourself tested or screened regularly.

Here's what you need to know about two simple, routine tests that could save your life.

Prevention is key to good health care. Screening and routine exams are some of the best preventive tools. These tests often can detect health problems in people who don't even have symptoms.

What kinds of tests are we talking about? That depends on your age and your risk factors. Women have changing health needs as they age. Where you live, your lifestyle and your personal and family medical history also factor into the type of tests you may need.

Routine screening

Routine screening for all women includes questions about your health and a physical exam. Your doctor may ask about your:

• Health history
• Family's health history
• Diet
• Exercise habits
• Use of tobacco, alcohol or drugs
• Sexual habits
• Medications

In a physical exam, your doctor may check your height, weight and blood pressure and may also do a breast exam and a pelvic exam.

Testing as you age

Two of the most important screening tests for women are the Pap test and mammography. The first is offered to women who are 21 or older, as well as those under 21 who have had sex. The second is key for women who are 40 or older.

The Pap test
After turning 21 or three years after first having sex (whichever comes first), a woman should start having a routine Pap test. Why? Because the Pap test is the best way to find cell changes that may lead to cancer of the cervix. Simple and fast, it's often done as part of a pelvic exam. While you lie on an exam table, the doctor uses a speculum to gently open the vagina and then removes some cells from the cervix. The sample is then sent to a lab, where it is examined for abnormal cells. Pap test results may be:

• Normal: no sign of changes in cells
• Atypical squamous cells (ASC): some cells that are not normal but also not identifiable as cells that may become cancerous
• SIL (squamous intraepithelial lesion): some changes that show signs of precancer. SIL can be low grade (mild) or high grade (moderate or severe)
• Atypical glandular cells: changes that need to be evaluated more closely
• Cancer: abnormal cells that have spread deeper into the cervix or to other tissues

Normal results are also called negative results. Sometimes, the results show abnormal cells when the cells are, in fact, normal–a "false-positive" result. Also, a Pap test may not detect abnormal cells that are there–a "false-negative" result. Your doctor may suggest a repeat test to check the results.

Sometimes a colposcopy may be advised. This exam, done in a doctor's office, uses a tool like a microscope to look at the cervix. It helps your doctor see changes that may mean abnormal cells are present. If an area of abnormal cells is seen, your doctor may decide that you need a cervical biopsy. That's when the doctor removes a small sample of tissue and sends it to a lab to be studied. A common type of biopsy is loop electrosurgical excision procedure, or LEEP.

If you are older than 30 and have had three normal results in a row, you may need to be tested only every 2 or 3 years. If the results are abnormal, or if you have had abnormal results before, your doctor may suggest having the test more often. If you have had a hysterectomy, talk to your doctor about whether you still need a routine Pap test.

Mammography
When women turn 40, mammography should become a part of routine screening. Mammography, an X-ray technique, can help detect breast cancer at an early stage. That's when treatment is more likely to be successful. Women aged 40-49 years should have the test every 1 to 2 years. At age 50 and older, it should be done every year. If you have certain risk factors, your doctor may suggest you have the test at a younger age.

The test can be uncomfortable but it's simple and does not take long. You undress above the waist and stand or sit in front of an X-ray machine. A technician places two smooth, plastic or glass plates on each side of one breast. They flatten it so the most tissue can be viewed with the least radiation. The plates may then be moved so that the breast can be X-rayed from other positions. The same technique is used for the other breast. The results are read by a specially trained doctor (radiologist).

Other tests

Other age-related tests for women who are 40 or older screen for high cholesterol, colon cancer, diabetes and thyroid disease. Women who are 65 and older should also have their urine and bone density checked each year.

Testing for risk factors

Some screening tests are triggered by risk factors. Some risk factors are genetic and some are environmental. Tests may be recommended if you have a family history of:

• Osteoporosis
• Some types of colon cancer
• Breast cancer
• Skin cancer
• Diabetes
• Genetic disorders or birth defects (especially if you're pregnant or planning to be)
• High cholesterol and lipid levels
• Thyroid disease

Tests may also be recommended if you regularly have contact in your work or social life with:

• People infected with HIV/AIDS
• People who may have STDs
• Tuberculosis patients
• Blood or blood products

With some kinds of screening tests, if you have a positive result, you'll need to do the test again, either to track the problem or to follow up after treatment.