If you have reached your 50s, here are some screenings and vaccinations recommendation to help you prevent health conditions that are more common at this age.
Colon cancer screening – Colon cancer is one of the most common cancers, and in HK, data suggest that up to 90% of colon cancers occur in those 50 years and above. Lifestyle factors and other conditions increase the risk of colon cancer.
Common screening tests are: Fecal occult blood test (FOBT), colonoscopy or sigmoidoscopy are the mainstays of screening. There are newer screening modalities such as virtual colonoscopy and stool DNA test.
Cholesterol levels – cholesterol levels are affected by family history (familial hypercholesterolemia), health conditions or lifestyle factors (such as diet, smoking and physical activity). Cholesterol levels go up with age as our bodies become less efficient at clearing cholesterol.
High cholesterol levels are associated with heart disease, stroke, hypertension and aortic aneurysm (ballooning of the aorta).
Blood Pressure – Hypertension is a chronic disease in which the pressure inside the arteries is persistently elevated. Blood pressure tends to increase as we age, and if not controlled can lead to serious conditions such as stroke, coronary artery disease, heart failure and kidney disease.
Regular blood pressure checks are important to catch the condition early.
ECG/Exercise ECG – Cardiac diseases can be detected by an ECG. An ECG can be used to look for any underlying abnormalities e.g. rhythm disturbances or infraction. If necessary, an exercise ECG can be performed.
Blood glucose – Diabetes Mellitus(DM) is a chronic condition which is caused by insulin resistance and deficiency, resulting in raised blood sugar levels. Both Type 1 DM (IDDM) and Type 2 DM (NIDDM) increase the risk of stroke, heart disease, retinopathy, neuropathy, kidney disease and foot ulcers.
DM is a major cause of illness and death. The prevalence of DM increases with age.
PAP smear/HPV test (women)
Cervical Cancer screening is for healthy women without any symptoms. In HK, women are encouraged to have a PAP smear, and if normal to repeat the second test a year later. If the second test is normal, the next test can be done 3 years later. A test for HPV can be performed at the same time as the PAP smear to look for high risk virus. If you have any symptoms, please see your doctor promptly.
Breast exam + mammogram (women)
Women should start screening in their 40’s. If you have not had a mammogram recently, please speak to your doctor. HK has not adopted a population-based mammography service for screening purposes but countries differ on their screening protocol (e.g. mammogram every 1-2 years for age 40 and above). If you notice any abnormalities or have a family history of breast cancer, you should see your doctor for further advice.
Prostate cancer screening (men)
There are 2 tests used for prostate cancer screening: digital rectal examination (DRE) and measurement of the prostatic specific antigen (PSA). The accuracy of DRE is dependent on the examiner, and the PSA test is affected by other conditions of the prostate other than cancer (such as prostatitis and benign prostatic hypertrophy).
If you have a family history of prostate cancer, are of black ethic origin, or are overweight or obese, a PSA test would be warranted.
Please speak to your doctor regarding benefits and harms associated with testing.
DEXA scan – It measures your bone mineral density and bone loss. Bone density decreases as we get older. If your bone density is lower than normal for your age, it indicates a risk for osteoporosis and bone fractures.
BRCA 1/BRCA 2test – these two genes are associated with an increased risk of breast and ovarian cancer in women, and male breast cancer and prostate cancer in men.
Shingles Vaccine – Shingles (herpes zoster) is the reactivation of the Varicella Zoster Virus (VZV), which causes chicken pox. If you have had chicken pox in the past, you are at risk of getting Shingles. Older people with Shingles are more likely to develop complications such as nerve pain (postherpetic neuralgia).
Pneumococcal vaccine –Pneumococcus cause severe or even life-threatening invasive pneumococcal diseases such as infections of the brain and the lungs. Those 65 or older are encouraged to receive this vaccine. However, you can receive it earlier if you have certain medical conditions (such as heart or kidney disease) which predispose you to the infection and possible complications.
Seasonal influenza vaccine – Influenza can cause acute illness of the respiratory tract and it may be complicated by bronchitis, chest infection or even death. An annual vaccination against seasonal flu is recommended, unless you have certain medical conditions or allergies which preclude you from having the vaccine.
Please feel free to make an appointment with our doctors to discuss your concerns so we can help optimise your health.
Centre for Health Protection, Department of Health, HKSAR
Centers of Disease Control and Prevention, USA
National Health Service, UK