In addition to general health assessments, specific tests and examinations are added to routine health care for all women once they reach a certain age.
' Annual digital exams for physical signs of rectal cancer, beginning at age 40. Some doctors begin these tests earlier for patients with high risk factors, others begin them later, at age 45 or 50. Aging is a primary risk factor for colorectal cancer, according to the American Cancer Society, with the odds of developing the disease increasing markedly after age 50. About 90% of all colorectal cancer cases worldwide are in people older than age 50.
' A fecal occult blood test, beginning at age 50. This annual exam looks for minute amounts of blood in feces'often a sign of colorectal polyps or colon cancer tumors, according to the American Cancer Society. Some doctors begin this annual test at age 40, says Tom Barrett, MD, a staff physician at Chicago's Howard Brown Health Center.
' Sigmoidoscopy or, preferably, colonoscopy exams to screen for colon cancer, beginning at age 50. These invasive but more accurate tests should be given every five years to look for colorectal polyps, which often develop into cancer tumors, and other visible signs of colon cancer. Sigmoidoscopy exams screen only about the lower third of the colon; colonoscopy exams check the entire length.
' An electrocardiogram, beginning at age 50. This annual test monitors heart function, says Roxanne Cox-Iyamu, MD, medical director for the northern Virginia office of the Whitman-Walker Clinic. Cardiovascular disease is the number 1 killer in the United States, according to the American Heart Association. About 62 million Americans are believed to have some form of cardiovascular disease, and 1 million die each year of heart attacks, strokes, and other cardiovascular complications.
' Clinical breast exams. These should be given about every three years for women in their 20s and 30s and every year beginning at 40 to screen for signs of breast cancer, according to the National Breast Cancer Foundation. Breast cancer is the most common cancer among U.S. women. Breast cancer risk gradually increases with age beginning in the 20s but increases dramatically after age 50. Half of all breast cancer cases are diagnosed in women over age 65.
According to the National Breast Cancer Foundation, clinical breast exams'and regular at-home screenings'can uncover such breast cancer warning signs as lumps, a portion of the skin on the breast or underarm that is swollen or has an unusual appearance, veins on the surface of the breast becoming more prominent, nipple leakage or physical changes in the nipple, and depressions in the area of the breast surface. About 70% of all breast cancers are found through clinical and self-administered exams. Women should check their own breasts every month beginning at age 20.
' Mammograms. These should be given every one to two years to all women beginning at age 40 and every year beginning at age 50, according to the National Breast Cancer Foundation. These tests may begin at age 30 for women with a family history of breast cancer. Mammography is a low-dose X-ray examination that can detect signs of breast cancer up to two years before tumors are large enough to be felt through clinical or selfadministered physical exams.
' Annual or even semiannual Pap smears for all sexually active women, says Judith Feinberg, MD, board chair of the American Academy of HIV Medicine. Because cervical cancer is considered an AIDS-defining illness, women infected with HIV are screened for it more often than HIV-negative women. Many doctors also offer tests that combine the regular Pap smear with a test screening for human papillomavirus infection, which has been linked with the development of the vast majority of cervical cancer cases.