Michael Bradshaw, Personal medical checkup, Kansas State University, August 1998

Bradshaw, Michael H.

K-State Research Exchange

FACT SHEET: Personal Medical CheckupHOW OFTEN SHOULD A PERSON HAVE A MEDICAL CHECKUP?The American Medical Association suggests that people have medical checkups every five years until age 40 and thenevery one to three years thereafter. One rule of thumb suggested: For individuals in their twenties — two exams during thattime period; in their thirties — three exams; forties — four exams. An annual health exam is recommended for most patientsafter age 50. It is always best to work with your clinician to decide what is best for you.WHAT MIGHT A PERSON EXPECT FROM A MEDICAL EXAMINATION?A complete family and medical history will be taken.The clinician should check or ask questions about the eyes, ears, nose, throat, abdominal area, swallowing,appetite, digestion, circulation and lungs. A urine specimen is used to test problems with kidneys; a bloodsample, to check cholesterol and any deficiency of iron.The clinician may request additional tests, depending on age, gender, medical history and family history. A chestX-ray, EKG, rectal examination, or stress test may be suggested. The clinician may suggest lifestyle changes andcall for health interventions. New patients should be quizzed about their medical history and that of closerelatives. There should be a few questions about their social history.There isn’t much counseling done at this time as it relates to lifestyle changes. A study by Consumer Reportsrevealed that patients don’t receive much counseling when they go in for their health checkups. One in fivereceives counseling about nutrition. One in seven is counseled about exercise. One in three smokers isencouraged to quit. One in 100 patients is counseled about injury prevention. (Consumer Reports August 1998) WHOM SHOULD YOU SEE?Consumer Reports suggests that family physicians and general internists are good choices. They receive themost training in preventive care. (Consumer Reports August 1998)Clinicians may counsel patients about some of the following health and behavior patterns to reducedisease, injury and premature death. The list below is for ages 25 and older.COUNSELING TOPICSubstance use Diet and exercise Injury prevention Sexual behavior Dental health Immunizations Hormone/Vitamins useTobaccocessationAvoid alcohol/drug use whiledriving,swimming,boating, etc.*Limit fat andcholesterolintake; maintaincaloric balance;emphasizegrains, fruits andvegetablesAdequatecalcium intake(women)Regular physicalactivity*Lap/shoulder seat beltsBicycle/motorcycle/ATVhelmets*Smoke detector*Safe storage/removal offirearms from the home*Fall prevention***Set hot water heater to120-130°F***CPR training forhousehold members***Prevention ofsexuallytransmitteddisease:avoid high-riskbehaviors*Regular visitsto dental careprovider*Floss, brushwith fluoridetoothpastedaily*Kansas State University Agricultural Experiment Station and Cooperative Extension ServiceTetanus-diphtheriaboostersRubella (womenof child-bearingage; serology orhistory ofvaccination)**Pneumoniavaccine***Influenza***Multivitamin with folicacid (women planning orcapable of pregnancy)**Discuss hormonereplacement (pre- andpostmenopausal women* The value of clinician counseling in influencing this behavior is unproven.** This applies only to people age 25-64.*** This applies only to people age 65 and older.Outdated Publication, for historical use. CAUTION: Recommendations in this publication may be obsolete.MAJOR SCREENING TESTSPERSONAL MEDICAL CHECKUP FACT SHEETBlood pressuremeasurement(to detect hypertension)All adults. Periodic screening.  Optimally onceevery 2 years for those with normalblood pressure.Those with elevated blood pressure need tobe under medical care.Cholesterol measurement All adults. At least once every 5 years, but morefrequently if total number is elevated,HDL is low, and/or you have cardiacrisk factors.The U.S. Preventive Services Task Forceand some other experts recommend screen-ing only men ages 35-65 and women ages45-65, but we advise screening all adults.Pap smear(for early detection ofcervical cancer)All women with a cervix, startingat age 18, or earlier if sexuallyactive.Every 3 years.  Possibly more often,depending on risk factors such assmoking or multiple sex partners.Some experts advise that women who havenever had an abnormal result can stopbeing screened after age 65.Breast cancer screening(mammogram and clinicalbreast exam)All women age 50 and over; those40-49 should discuss their riskfactors with their doctors.Annually.  Medicare reimburses onlyfor every other year.There is debate about screening those intheir forties; the National Cancer Instituteis reviewing its guidelines for them.Colorectal cancer screening(fecal occult blood test and/or sigmoidoscopy)Everyone age 50 and over; earlierfor those at high risk.Occult blood test annually;sigmoidoscopy every 3-10 years, onprofessional advice.There’s still debate about the usefulness ofoccult blood test.  Digital rectal exam mayalso be done.Prostate cancer screening(prostate specific antigen,or PSA test, and digitalrectal exam)Routine screening is notrecommended.  However, men over50 who are black or have a familyhistory should consider testing.On professional advice. Usefulness of PSA test for screening all menremains controversial.Thyroid disease screening People over 60, especially women,should discuss with doctor.On professional advice. If you don’t have symptoms, there may beno reason to be tested.Glaucoma screening People at high risk: those over 65,very nearsighted, or diabetic;blacks over 40; those with a familyhistory.On professional advice of eyespecialist.Many eye specialists advise screening alladults starting at age 40 or 50.Dental checkup All adults. On professional advice. If you don’t have symptoms, there may beno reason to be tested.Tetanus/diphtheria booster All adults. Every 10 years. People over 50 are least likely to beadequately immunized.Influenza vaccine Everyone 65 and over, people withlung or heart disease or cancer, andothers at high risk.Annually, in autumn. Even healthy younger adults can benefitand should consider getting the shot,according to a 1995 study.Pneumococcal vaccine Everyone 65 and over, and othersat high risk for complications.At least once. Effective against most strains of pneumonia;lasts 5-10 years.Rubella vaccine All women of childbearing age. Once. Avoid during pregnancy.Hepatitis B vaccine All young adults, as well as adultsat high risk.On professional advice. All newborns should be vaccinated.Reprinted with permission from the University of California at Berkeley Wellness Letter, © Health Letter Associates, 1997. To order a one-year subscription, call (800) 829-9170.Publications from Kansas State University are available on the World Wide Web at: http://www.oznet.ksu.eduContents of this publication may be freely reproduced for educational purposes. All other rights reserved. In each case, credit Michael Bradshaw, Ph.D., “Personal Medical Checkup,” Kansas State University, August 1998.Kansas State University Agricultural Experiment Station and Cooperative Extension ServiceMF-2357 AUGUST 1998It is the policy of Kansas State University Agricultural Experiment Station and Cooperative Extension Service that all persons shall have equal opportunity and access to its educational programs, services, activities, and materialswithout regard to race, color, religion, national origin, sex, age or disability. Kansas State University is an equal opportunity organization. Issued in furtherance of Cooperative Extension Work, Acts of May 8 and June 30, 1914, asamended. Kansas State University, County Extension Councils, Extension Distr icts, and United States Department of Agriculture Cooperating, Marc A. Johnson, Director.File code: HEALTH AND SAFETY NPSERVICE WHO NEEDS HOW OFTEN COMMENTSOutdated Publication, for historical use. CAUTION: Recommendations in this publication may be obsolete.

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