In this excerpt from a recent Health After 50 newsletter article, Johns Hopkins explains the difference between screening and diagnostic tests and provides a handy list of screening tests recommended for adults aged 50 and older.
A screening test looks for signs of an illness before symptoms develop. A diagnostic test provides information about a known problem or looks for disease after an illness is suspected.
For example, a blood test for prostate specific antigen (PSA) may be used to screen men for prostate cancer. But if PSA is elevated, a biopsy (a diagnostic test) is needed. Similarly, mammography is used to screen women for breast cancer, but a biopsy is needed to evaluate suspicious findings. In some instances, the same tests are used for both purposes, as when mammography is ordered to evaluate a suspicious breast lump. Some tests, such as PSA, may also be used to monitor response to treatment.
Here is a listing of recommended screening tests for women and men after age 50:
Screening Tests For Women:
- Pap test (cervical cancer) -- Every three years if results are negative for three consecutive years; annually if you smoke or have multiple sex partners.
- Human papillomavirus (HPV) test (cervical cancer) -- May be done along with a Pap test; not enough evidence to recommend routine screening.
- Mammography (breast cancer) -- Annually for all women 50 and over.
- Thyroid-stimulating hormone (TSH) test (thyroid disease) -- The United States Preventive Services Task Force doesn't recommend screening asymptomatic women, but other groups do. Talk to your doctor.
- Dual-energy x-ray absorptiometry bone density test (osteoporosis) -- Once every two years beginning at age 65. Women with risk factors, as determined by their primary care providers, should begin at age 60.
Screening Tests For Men:
- Prostate specific antigen test and digital rectal exam (prostate cancer) -- Black men and men with a family history of prostate cancer should begin annual screening at age 40. Others should begin at age 50.
- Abdominal ultrasound (abdominal aortic aneurysm) -- Once only for men 65–75 who've ever smoked.
Screening Tests For Everyone:
- Blood pressure check (cardiovascular disease) -- Once every two years; more frequently for people over 60 or with readings over 120/80 mm Hg.
- Cholesterol and triglyceride levels check (cardiovascular disease) -- Once every five years; more frequently for people with a family history of heart disease.
- Colonoscopy (colon cancer) -- Once every 10 years beginning at age 50; more frequently for those at high risk.
- Fecal occult blood test (colon cancer) -- Annually, although its unreliability leads many organizations, including Johns Hopkins, to question its usefulness.
- Fasting blood glucose test (diabetes) -- Every two to three years; more often if you're at high risk.
- Sexually transmitted disease screening test -- At least once a year if you have multiple partners.
- Glaucoma screening test -- Every three to five years; more often for people with diabetes or family history of glaucoma.
- Dental cleaning and exam -- Every six months.
