Since the pandemic began two years ago, you probably skipped a few routine doctor’s visits. Maybe there was (and probably still is) a backlog at your local hospital and you were meant to reschedule a screening, but never did. Or you haven’t wanted to occupy your GP’s time with a regular checkup. It’s understandable. But keep in mind that you could be putting your health at risk by letting things slide.
“Oftentimes, certain illnesses and cancers will not have any symptoms until later on,” says Dr. Jennifer Kwan, a family doctor in Burlington, Ont. “For example, high cholesterol or high blood pressure may not cause problems for years, until someone has a heart attack or stroke.”
Many of the most serious chronic diseases can be nipped in the bud if they’re caught early enough, says Kwan. That’s why you should be booking that potentially long-overdue Zoom visit with your family physician—even if you don’t have any specific concerns. Here’s everything you should get checked out and the routine—but potentially lifesaving—tests and procedures you should be scheduling at your next appointment.
Book a Pap test
Regular pelvic exams and pap tests help detect cervical and vaginal cancers early on in anyone with a cervix. “Cervical cancer may not even cause any symptoms until later stages, which makes it hard to detect without Pap smears,” says Kwan.
The Society of Obstetricians and Gynaecologists of Canada recommends a Pap test every three years starting at age 21, or once sexually active. There are some situations in which more frequent screening is required (like in a case where abnormal cells are found) and depending on where you live, screening might be recommended every two years. Ask your doctor or local sexual health clinic for the guidelines in your region.
Sexually transmitted infections (STIs) have been on the rise, and Pap tests can help detect some of them, too. Some of the most common ones, like chlamydia and gonorrhea, often have no symptoms. The Public Health Agency of Canada recommends screening for chlamydia in pregnant women, annual screening for sexually active individuals younger than 25, and targeted screening for those over 25 who are at-risk (which would include someone with a previous STI, for example). These screenings can often be done at the same time as a Pap test (though screening for HIV, syphilis and hepatitis B and C requires a blood test).
Get your blood pressure checked
Hypertension Canada recommends annual blood pressure testing for all adults, since hypertension is the main risk factor for stroke. In general, a reading of 135/85 or higher is considered high risk (though someone with diabetes should be scoring less than 130/80). Blood pressure is typically checked if you receive a yearly health visit, but it may need to be taken more often if your pressures are too high or too low.
Make sure your immunizations are up to date
Aside from your COVID-19 shots, talk to your family doctor to determine which vaccines you might need. Tetanus boosters are recommended every 10 years, HPV vaccinations are often recommended for people under 45, and then there’s the annual flu shot. Over age 50, there are also pneumonia and shingles vaccines available. And if you are considering booking a far-flung holiday, you may need travel vaccines for hepatitis A and/or B, yellow fever or typhoid.
Get your cholesterol checked
The only way to know if you have high cholesterol, which puts you at increased risk of heart attack and stroke, is with a blood test. The Heart and Stroke Foundation of Canada recommends cholesterol testing after age 50 (or post-menopause) for women, or sooner if you have heart disease, diabetes or high blood pressure, or if you have other risk factors for cardiovascular disease. Your family doctor can discuss your risk and whether you need testing at your next health check-up.
Your GP may also recommend screening for Type 2 diabetes if you’re over 40 and/or at high risk of developing the disease. Risk factors include a first-degree relative with Type 2 diabetes, being a member of a high-risk population (African, Asian, Hispanic, Indigenous, Arab or South Asian) and/or having an associated disease, like polycystic ovary syndrome.
Inquire about a colonoscopy
“Colon cancer screening is also recommended, typically starting at age 50,” says Kwan. Your family doctor will provide you with a home screening tool called a fecal immunochemical test (or a FIT kit), which detects trace amounts of blood in stool. The results of a home test and/or high risk factors (like a family history of colon cancer or polyps) will determine if a colonoscopy is required. At-home stool screenings are generally recommended every two years.
Go for a mammogram
The Canadian Cancer Society recommends mammograms between the ages of 50 and 74, but screening standards vary across the country. If you live in British Columbia, Nova Scotia, Prince Edward Island or Yukon, you can book your own mammogram any time after age 40. Elsewhere, you need to go through your physician, which a recent survey by Dense Breasts Canada found can lead to screening delays and even refusals.
To add to the confusion, only six provinces inform patients about their breast density in their results (dense breast tissue is a key risk factor for cancer). Plus, only six jurisdictions offer patients with category D density (the most dense tissue) annual mammograms. Talk to your doctor and check out Dense Breasts Canada for more on your eligibility for screening and your individual risk factors.
“If you notice changes in your breasts, such as lumps, skin changes, pain, nipple discharge or bleeding, then you should call your doctor right away and not wait for a screening mammogram,” says Kwan.
What if I don’t want to Zoom with my GP?
Many doctors are still scheduling virtual visits for appointments that can be easily done over the phone, or on the computer, such as prescription renewals or testing referrals. If your doctor’s office is prioritizing Zoom calls, but you would prefer an in-person visit, start with a phone call to explain your concerns; most doctors will book face-to-face appointments, too. And, of course, your doctor will want to see you in-person for any concern or screening test that requires a physical exam.
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