Health Screening Recommendations

General Recommendations

Regular visits to your primary care are important both to review ongoing medical concerns, but also to plan strategies to prevent other medical problems from occurring in the first place. Some of these evaluations include screening for colon cancer, osteoporosis, cervical cancer (PAP tests), and breast cancer (mammograms). Below is some information to help you when discussing with your doctor or NP.

Colon Screening Recommendations

Colon cancer is the 3rd most common cancer in the United States, and the 2nd most common cause of cancer related deaths. Many of these are preventable. Most colon cancers develop from certain types of polyps (adenomas); these types of polyps can grow in up to 30% of people over age 50. The risk for these polyps goes up with age. Some patient populations are also at higher risk for polyps.

The US Preventative Services Task Force (USPSTF) and other health groups urge adults age 50 -75 to screen for colon cancer, and recommend 3 options:
  1. Fecal occult stool blood testing yearly (“stool cards”),
  2. Screening Colonoscopy every 10 years, or
  3. Flexible Sigmoidoscopy every 5 yrs, combined with fecal occult stool tests every 3 yrs.
Please discuss with your health care provider which of these options would be best for you.

Osteoporosis Screening Recommendations: Should you get a DEXA scan?

Osteoporosis is a condition of decreased bone strength, with increased risk for fractures. Women become more likely to have this, or its milder version, osteopenia, after menopause. Prevention and treatment are available, and a screening Xray test (DXA or DEXA) is recommended for all women over age 65 and for women over 60 with increased risk factors.
DEXA scanning is available for all our patients, with studies done at our clinics in North Portland, Oregon City, and Tigard. Please ask your health care professional if you would benefit from this test.

Mammogram Recommendations

In November 2009, the US Preventative Services Task Force (USPSTF) made new recommendations for screening mammograms; with much discussion by the medical community, these were revised in December 2009. Their current recommendations are for routine mammogram screening to begin for women at age 50, with every 2 years mammogram up to age 74. Women should discuss with their medical care provider if Mammography would be appropriate during ages 40 – 50, if should be done yearly for ages 50 – 74, or if screening should be continued after age 75. Some medical groups agree with these recommendations (American Academy of Family Physicians), while others urge regular mammograms yearly starting at age 40, closer to the previous recommendations (American Cancer Society -ACS). Please discuss with your doctor or NP what makes sense for you.

Pap Recommendations

The Papanicolaou Smear is a microscopic evaluation of cells from a woman’s cervix. This Cytology screening test looks for abnormalities that may suggest cancer or pre-cancer conditions. The United States Preventative Services Task Force (USPSTF) strongly recommends screening for cervical cancer in women who have ever had sex and have a cervix. The American Congress of OB/Gyn recommends Pap screening begin at age 21, if normal, continue every 2 years between the ages of 21 – 29; every 3 years after age 30 (if low risk and 3 tests in a row were normal). The American Academy of Family Physicians and the USPSTF recommend screening every 3 years. If Pap tests have recently been adequate and normal, the USPSTF recommends against routinely screening woman older than age 65 that are not otherwise at high risk for cervical cancer.