GENERAL HEALTH SCREENING: TONOMETRY SIGMOIDOSCOPY AND OTHERS
Tonometry
This is a simple, painless method of measuring the pressure of the fluid in the eyeball. It is valuable to be aware of this pressure because an early rise, if caught, can be treated and can save the person’s sight. It is a test worth doing every two to five years after the age of 40.
Sigmoidoscopy (Looking inside the rectum or back passage)
Most cancers of the bowel lie within the view of a special instrument, called a sigmoidoscope. It is generally considered sensible to have a sigmoidoscopy every three to five years following two negative examinations a year apart at age 50. Other experts recommend one examination at age 56 because this is the peak age for this cancer, which is the second commonest.
Testing the stools for blood
Because microscopic amounts of blood can be lost in the stools in people who have bowel cancers this can be a very good way of detecting such cancers early and certainly long before they start to produce symptoms. It is probably sensible to have such a test done every year after the age of 50.
Testing for anaemia
Recommendations for the screening of adults for anaemia range from, every two to every five years. Women are particularly at risk because of having periods and childbearing. Many millions of people, women especially, are walking around sub-clinically unwell with anaemia yet remain unscreened. This is an easy and cheap test to do and the treatment is straightforward and inexpensive.
Blood sugar tests
Whether or not it is worth screening populations for their blood sugar levels to see if they are undiagnosed diabetics is controversial-mainly because there is no evidence yet that the early detection of diabetics without symptoms does anything to alter the long-term outlook. Some experts think that as the test is relatively cheap it is worth doing every five years until 65 and then every two years. Others feel that looking for sugar in the urine (another sign of diabetes) every five years is quite sufficient.
Screening for sickle cell trait
Certain high-risk populations (mainly black) should be screened prior to childbearing so that they can receive genetic counseling about the likelihood of having an affected baby. Some experts recommend that the test be done at the age of 10 years.
Checking for German measles (rubella) immunity
This disease, whilst not serious during normal life, can produce terrible handicaps in the baby of a pregnant woman who catches it. It is estimated that even with rubella vaccinations being widely available, about 15 per cent of women get to childbearing with no immunity to the disease. The most logical time for screening is just before childbearing age. Pregnancy should not be allowed to occur for three months after the immunization. A girl who is not immune can be vaccinated in her early teens. Many authorities think that every pregnant woman should be routinely tested for antibodies to rubella.
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