Preventive care: checkups, screening tests and staying well

Most people see a doctor when they feel ill. Preventive care is different: it aims to keep you well and to find problems early, when treatment is often easier. This article explains the main parts of preventive care in modern medicine, often called allopathy, using information from the US Centers for Disease Control and Prevention (CDC), MedlinePlus, the World Health Organization (WHO) and India's national programme as described by WHO. It is general information and your doctor can advise on what suits you.

1. Introduction

The CDC says that healthy choices can prevent many chronic diseases and lower the risk of severe illness from some infections, and that routine preventive care helps you stay well and catch problems early ^[1]. Preventive care is separate from visits for an illness or injury ^[1].

2. What a routine checkup includes

According to the CDC, a checkup includes a physical exam and focuses on prevention. The services can include screening tests for diseases that are easier to treat when found early, vaccinations, dental cleanings, and education and counselling to help you make informed decisions ^[1].

3. What screening means

Screening means checking for a disease before you have symptoms ^{[1, 2]}. MedlinePlus says screening can find conditions early, when treatment is often easier. Some screening is done in a doctor's office, while other tests need special equipment at another clinic ^[2].

Which tests you need depends on your age, sex, family history and risk factors ^[2]. MedlinePlus lists conditions that doctors commonly screen for ^[2]:

• Breast and cervical cancer in women.
• Prostate cancer in men.
• Colorectal (bowel) cancer.
• Diabetes.
• High blood pressure.
• High cholesterol.
• Osteoporosis, a condition that weakens bones.
• Overweight and obesity.

Examples of cancer screening

The CDC describes the aim of several tests ^[1]:

• Cervical: a Pap test finds abnormal cells that could become cancer, and an HPV test looks for the virus that causes those changes.
• Colorectal: screening can find precancerous growths called polyps so they can be removed, and can find cancer early.
• Breast: ask your doctor which tests are right for you and when to start.
• Lung: yearly low-dose CT scans are recommended in the United States for some people aged 50 to 80 with a history of heavy smoking who smoke now or quit within the past 15 years.

Guidelines differ between countries, so ask your own doctor which schedule applies to you in India or elsewhere.

4. Know your family health history

A family health history is a record of diseases in your family. The CDC says a family history of conditions such as cancer, heart disease, diabetes or osteoporosis raises your own risk. You cannot change your genes, but you can change behaviours such as smoking, poor nutrition, inactivity and excessive drinking, and people with a family history may benefit most from those changes and from preventive care ^[1]. To build your history, talk to relatives on both sides of the family about major conditions and the ages at which they were diagnosed ^[1].

5. Vaccines as prevention

The CDC says vaccines are one of the safest and most convenient ways to protect your health, and that adults need updates because childhood immunity can fade and adult risks differ ^[1]. Everyone aged 6 months and over is advised to have a flu vaccine each season in the United States, especially people at higher risk ^[1]. Ask your doctor which vaccines suit you in India or elsewhere.

6. Screening in India

WHO describes India's government programme of population-based screening for common noncommunicable diseases. It covers high blood pressure, diabetes and three cancers: oral, breast and cervical. It is delivered through Health and Wellness Centres as part of comprehensive primary health care, and by March 2021 it had covered about 64 million people aged over 30 ^[3]. It focuses on districts with poor socio-economic indicators ^[3]. Risk scores help prioritise people at higher risk, such as users of smokeless tobacco, who face a higher chance of oral cancer ^[3]. Suspected cases are referred for confirmation and follow-up ^[3]. WHO says noncommunicable diseases such as heart disease, diabetes and cancers now account for 64 percent of India's disease burden ^[3]. Ask at your nearest primary health centre what is available locally.

7. Limits of screening

No test is perfect. MedlinePlus explains that a false positive shows a problem that is not there, and a false negative misses a real one. Both are uncommon but possible, and a normal result does not guarantee good health, especially if you have symptoms ^[4]. A result outside the typical range does not always mean disease ^[4]. That is why a screening result is followed by a conversation, and sometimes by more tests, rather than being treated as a final answer. Home test kits should not replace tests ordered by your provider ^[4].

8. Making screening work for you

• Ask your doctor which screening tests are right for your age, sex, family history and risk factors ^[2].
• After any test, ask when you will get the result and who will explain it ^[2].
• Keep your records, including vaccines and test reports, in one place.
• Tell your doctor about all medicines and supplements, because these can affect results ^[4].

9. When to see a doctor

Book a checkup if you have not had one for some time, if a close relative develops a serious condition, or if you are due for a screening test or vaccine. See a doctor promptly for new symptoms, and do not wait for your next routine check if something worries you, because screening is for people without symptoms. In an emergency, call your local emergency number (112 in India, 911 in the United States).

10. Conclusion

Preventive care combines regular checkups, screening, vaccines and healthy behaviours. Screening works best when it matches your risks and when results are followed up. Because tests have limits, the most useful step is a regular conversation with your doctor about what to check and when.