Health Screening, Life Saver! - Dr. Ching Shih Kiat, Senior President Physician, Raffles Hospital, Singapore

Dr. Ching Shih Kiat, Senior President Physician, Raffles Hospital, Singapore

If a staff was asked to go for health screening 15 years ago, they would be worried as health screening was used as platform by the company to find fault with the staff and trigger a termination of employment . Thankfully this view has changed over the years.

Nowadays,health screening is perceived as one of the necessary tools for people to maintain their health. As the saying goes, prevention is better than cure. In the local context, we know that 1 in 5 Singaporeans have high blood pressure, high cholesterol levels. We also know that 1 in 4 Singaporeans will suffer from cancers.Early detection for any diseases will ensure better treatment outcomes.

Health screening is not a laborious activity.Short of the discomfort of fasting for 8 hours, a regular standar health screening can be completed well within an hour. A standard health screening is one that screens for glucose and cholesterol profiles, a kidney function through a urine test, a stool occult blood testing, body height and weight measurements and a blood pressure measurement. These are the bare screening requirements for those above 40 years old.

However, a standard screening may not be suitable for every people. That is where the doctor's medical review and examination plays its role. Through the consultation with the doctor, further investigations may be deemed necessary for a complete assessment of the patient's health.

Health screening, carried out at least once every two years, enables us to have a peek into our health so as to allow us to make adjustments to our lifestyle in order for us to maintain our health. Health screening, being so easily carried out, yet comes with huge preventive health benefits, is something that everyone should not miss out on .

12 Main Health Tests

When: From 40, you should have checked at least once a year

How: Ask your GP to test it for you

What it means: If the diastolic (blood pressure when the heart relaxes) is at 90mmHg (millimetres of mercury) or above, and your systolic (blood pressure when the heart is pumping)is at 140mmHg or above, you have high blood pressure. Left unchecked, it can lead to heart and kidney failure - these can be prevented with early detection and treatment.

When: from 40, you should have it checked every three years. Earlier and more frequent screening if you are a current smoker, has a history of diabetes, heart attack, stroke or have family history of high cholesterol.

How: a blood test that tests for the three types of fats in the body - 'bad' cholesterol, 'good' cholesterol and triglycerides - you need to fast for about 8 hours before the blood test.

What it means: the higher it is , the greater chance you have of heart disease.

When: from the age of 18, you should monitor your weight regularly.

How: using the Body Mass Index (BMI), which takes your weight (kilogrammes) and divides it with the square of your height (metres). A healthy weight is a BMI of 18.5 -22.9 , overweight is 23 - 27.4 and obese is 27.5 and above.

What it means: if your weight is over the normal range for height and age, it can translate to higher risk of acquiring diabetes, high blood pressure, heart disease, stroke and some cancers.

DIABETES MELLITUS

When: from 40, you should be tested every three years. Screening should start earlier such as from 30 if you have history of high blood pressure, are overweight, have a close relative that has diabetes, have heart disease or have had diabetes during pregnancy.

How: a blood test is taken for blood glucose.

What it means: if the blood glucose is high, it means you have diabetes. Diabetes is a result of inadequate insulin production by the pancreas or ineffective insulin effects leading to higher levels of glucose in the blood. This leads to damage and failure of organs such as the eyes and kidneys, and may result in kidney failure, strokes, heart attacks and blindness.

COLORECTAL CANCER
How: a stool test can be done from age 40 onwards. A colonoscopy test is recommended once every 10 years from age 50.
When: stool test is done annually. For colonoscopy, once every 10 years if the test is clear and there are no other risk factors. If you are considered to be in the high-risk group, you will need to do a colonscopy at a younger age, and more frequently. High risk means one of your close relatives eg immediate family members had suffered from colorectal cancer . Women who have had cancer of the womb,ovaries or breast may also have a higher risk of acquiring colorectal cancer.
What it means: cancer of the colon and rectum is the most common cancer in Singapore and is curable if discovered early.

The doctor will carry out a prostrate specific antigen (PSA) screening ( done through a blood sampling ) and perform a digital rectal examination to assess the size and surface regularity of the prostate gland.

When: From age 30 onwards, a lady is advised to do breast self-examination every month after her period. A mammogram should be performed every year between 40 to 50 years of age. Women over 50 should be screened with a mammogram oncer every two years.

How:Mammography is the recommended screening tool for early detection of breast cancer. An ultrasound breast examination or MRI scanning of the breast is recommended if a mammogram is inconclusive.

What it means: This is the most common cancer among women in Singapore. Early screening will detect it in the early stages for effective treatment. For women with a family history of breast cancer in the first-degree family members, screening should be started 5 years prior the age of diagnosis in the relative.

How: A Pap smear is a clinic procedure where the doctor examines and performs a swab to sample cervix cells onto a glass slide. The slide is sent to a pathologist for examination under the microscope.

What it means: Cervical cancer is the fourth most common cancer in women . You are in the high-risk category if you are a current smoker, have had multiple sexual partners, have no regular Pap smear screening, have had sexual intercourse at a young age, have had a history of sexually transmitted disease or HPV (human papilloma virus) infection.

When: Advised to have screening from age 50, but recommended to be earlier if you have any of the listed risk factors such as current cigarette smoking, history of previous fractures, early menopause, low physical acitivity and low calcium intake etc . If your results showed a mild decrease in bone mass, you may be screened every one to five years . If the bone mass is normal, a screening is advisable to be done once every five years.

When: Everyone should be screened for Hepatitis B infection. Screening is more important if you are pregnant, a healthcare worker or if you have a family history of Hepatitis B infection or liver cancer.

How: A blood test will tell if the HBV ( Hepatitis B virus ) antibody, that keeps you immune from Hepatitis B, is present. The blood test will also show whether you have the HBV antigen. The results will alow the doctor to assess whether you are a Hepatitis B carrier and will therefore require regular follow-up. If you are not a Hepatitis B carrier, the doctor will also be able to advise whether vaccination is necessary.

What it is: About 6 percent of Singaporeans have chronic hepatitis B infection (HBV) 25% of hepatitis B carrier will suffer from liver cirrhosis and liver cancer. It is therefore important to be screened.

When: If you havea history of hypertension , diabetes, high blood cholesterol levels or a family history of heart diseases, you should consider going for a cardiac screening once every two or three years.

When: If you are not at risk, there is no need to screen. However, those with excessive alcohol intake, history of chronic hepatitis B infection or hepatitis C infection should be screened regularly.

How: Screening test include blood assessment of liver function , serum alpha-fetoprotein levels ( a tumor marker for liver cancer ) every three to six months and an ultrasound for the liver yearly.