5 life-saving tests

Sometimes, we need to take our health into our own hands. While screening tests such as mammograms and PAP smears get a lot of press, more modestly publicized tests may be just as important to your long-term health.

You can't count on your doctor to remind you of an upcoming date on your "maintenance schedule," because doctors vary widely in their approaches to testing. Some test their patients annually for a variety of health conditions, others test every few years, and still others test only high-risk patients. Here are five key medical tests you should know about and discuss with your doctor.

1. Blood sugar
The fact that more than two million people are living with diabetes in Canada indicates that no woman can afford to ignore her blood glucose (sugar) levels. Dr. Sharon Domb, medical director of the department of family and community medicine at the Sunnybrook and Women's College Health Sciences Centre in Toronto, advises having your blood glucose tested every two years, and once a year if you have risk factors such as obesity or a family history of Type 2 diabetes. "If you catch your rising glucose levels at an early stage, diet and exercise can do a lot to stave off diabetes," she says. A fasting blood-glucose test requires that you consume nothing except water for 12 hours before having your blood drawn, usually first thing in the morning.

2. Thyroid function
Because the risk of hypothyroidism, or poor thyroid function, increases with age, the American Medical Association recommends having your thyroid-stimulating hormone (TSH) tested once a year after age 55. "The higher your TSH, the poorer your thyroid function," says Dr. Sabrina Gill, an endocrinologist at St. Paul's Hospital in Vancouver. If you're over the age of 35, you should have a regular blood test to screen for thyroid dysfunction; start earlier if you have a family history or symptoms of hypothyroidism. These symptoms include fatigue, lethargy, weight gain, heavy periods, and feeling cold when everybody else is comfortable.

3. Colorectal cancer
If you're over 50, you need to start thinking about the health of your colon and rectum, as colorectal cancer becomes much more common after this age. If your doctor doesn't take the initiative, you can request to have a stool analysis every year after your 50th birthday. You'll have to follow a special diet for a few days before collecting your stool sample and bringing it to the lab.

The presence of "occult" or hidden blood in the stool suggests the possibility of colorectal cancer, and needs to be followed up with a colonoscopy -- an examination of the lower bowel with a long tube. If you have a family history of colorectal cancer -- even if you're under 50 -- Dr. Domb says you should skip the stool analysis and go straight for the colonoscopy.

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4. Chlamydia
Causing few or no symptoms in many women, chlamydia can conceal its damaging effects for years. With timely treatment, however, most women recover from chlamydia without long-term damage. According to Dr. Marc Steben, a consultant to the infectious disease unit at the Montreal Public Health Authorities, the prevalence of chlamydia in Canada has been climbing steadily since its low point in 1996. In 1999, close to 30,000 Canadian women contracted the disease, along with about 12,000 men. Why the discrepancy? "Women are more prone to all sexually transmitted infections because there is more surface area in the cervix," says Dr. Steben. "Also, infected semen has a longer time of contact in the cervix. The time of contact is less for men [because of their physiology]."

While a urine test for chlamydia has recently become available, Dr. Steben prefers the old-fashioned cervical swab, which he considers more reliable. As to frequency of testing, Dr. Domb recommends "once for each new monogamous relationship, and every few months if you're sexually active with partners who may not be monogamous -- and, of course, whenever you have symptoms suggestive of a sexually transmitted disease."

5. Visual skin check
Your lifetime risk of melanoma -- the type of skin cancer that can spread -- is about six to seven per cent, still higher if you have a fair complexion or an abundance of moles. Regardless of your skin type, Dr. Barbara Kellner, a practising dermatologist and assistant clinical professor at the University of Calgary, recommends a yearly whole-body skin check by a family doctor or dermatologist. Even more useful, she says, is to do your own checks every few months. "We know that the person most likely to pick up early melanoma, when it's highly treatable, is the patient herself."

What to look for? It's as simple as ABCD: A for asymmetry, B for border irregularity, C for colour variation (watch for dark brown, black or red undertones or mixed colours), and D for diameter, a red flag being a diameter of at least the size of a standard pencil eraser.

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