GENERAL HEALTH SCREENING: TESTING BLOOD FAT LEVELS SYPHILIS AND GONORRHEA TESTS
Testing blood fat levels
High blood cholesterols are clearly associated with a risk of heart attack but blood triglycerides (another sort of fat) are not. Screening for cholesterols is recommended every five years from the late teens. They are not worth screening for past 65.
Syphilis tests
Three-quarters of all cases of undetected syphilis will eventually develop incurable ‘tertiary’ complications which are very severe indeed. The ‘at-risk’ group is the 20-50 range. Recommendations for screening vary greatly but it is probably sensible to do one test when the person becomes sexually active and every five years after that to age 50. Pregnant women should be screened for syphilis as a routine
Gonorrhea tests
This is a disease without symptoms in 75 per cent of women and 10 per cent of men. Some people feel that screening is not warranted because the disease is relatively easy to treat, and because however well we screen we shall never be able to eliminate the disease from the population most at risk. Others recommend that yearly screening be done from the time a person becomes sexually active. Perhaps a good compromise is a test at the time of the first pelvic examination and then every five years to 44.
This disease, which can cause mental handicap if not detected and treated very early in life, is already routinely screened for at birth.
Chest X-rays
Because of the low cure rates of lung cancer (8 per cent survive 5 years, regardless of the stage of the tumour at detection), it is now no longer thought reasonable to do chest X-rays as a screening procedure. ‘At-risk’ populations should still be screened for tuberculosis though. Perhaps a baseline chest X-ray at 35 or 40 is sensible with a repeat at five- or ten-year intervals.
Electrocardiograms
It is useful to have a baseline ECG done at about age 35-40 with repeats every five to ten years.
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