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There are two gender-specific 'p' words that are not used in polite conversation. No, get your mind out of the gutter, I'm not talking about those ones. I was, of course, referring to 'prostate' and 'pap smear' — two (okay, three) words bound to cause uncomfortable grimaces on the faces of most men and women.
But as uncomfortable as these words (and corresponding tests) make us feel, they are one of the unfortunate facts of life. Pretending that the tests don't exist or that you don't need to be tested (yet), does not decrease your chance of getting cancer. In fact it increases it.
You need to be proactive about your health. There are a number of 'silent killers' which only make themselves known when it is too late and you need to go for preventative checkups to make sure that none of these are quietly sneaking up on you.
We have compiled a list of all the tests you should be taking, with details on what, exactly, they involve, how often you need to be tested and what you should do in preparation.
General
Test: Blood pressure
Why have it? High blood pressure can cause heart attacks and strokes. By having it checked you can make lifestyle changes or go on medication if necessary.
Who should have it? Annual checks for everyone over 18 years.
What does it involve? Blood pressure is measured using a sphygmomanometer (inflatable cuff and stethoscope). It is a painless procedure which momentarily stops the blood flow in your arm. The test measures the force of blood on the artery walls as the heart pumps blood through the body.
A blood pressure reading contains two figures. The first (systolic) is the pressure at the point when the heart contracts, the second (diastolic) is the lowest point of pressure between two heartbeats. A normal reading is between 120-130/80-85 mmHg.
Preparation: Try to relax before the test and avoid caffeine, tobacco and alcohol for at least 30 minutes.
Where? Most pharmacies and GPs.
Test: Blood glucose
Why have it? Blood glucose is an indicator of type two diabetes. Unchecked diabetes can lead to heart disease, kidney damage, strokes and poor circulation. However, if detected early it can be properly treated and managed.
Who should have it? Annual checks for everyone over 40
What does it involve? There are two possible tests which you could have to test blood glucose levels. The first is a finger prick test, where a drop of blood is placed on a strip which is read by a glucometer. An acceptable score is 6.5mmol/l or lower. If you score higher you will probably have to have a urine dipstick test which measures the excess glucose excreted in your urine.
Preparation: Avoid eating six hours before the test, but drinking water is fine.
Where? Most pharmacies and GPs.
Test: Cholesterol test
Why have it? High cholesterol can lead to heart attacks. Although lifestyle factors strongly influence cholesterol levels, there is also an inherited form of hypercholesterolaemia (high cholesterol) that can affect young people.
Who should have it? Annual checks for everyone over 18 years.
What does it involve? It is a simple blood test that measures the amount of cholesterol in your blood. An acceptable score is 5mmol/l or less, however not all cholesterol is bad. If your levels are higher than 5.5mmol/l then a more intensive test — a lipogram — which considers both good (high density lipoprotein) and bad (low density lipoprotein) cholesterol is necessary.
Preparation: Avoid fatty foods and alcohol the night before.
Where? Most pharmacies and GPs.
Test: Tonometry (glaucoma)
Why have it? Glaucoma is a disease characterised by increased eye pressure, which can lead to blindness. Because there are no symptoms in the early stages, it usually goes undetected until 'blind spots' appear by which stage it is too late and irreversible nerve damage has been done. Early intervention can prevent blindness.
Who should have it? Everyone over 40, every three to five years
What does it involve? The test is painless, but might be uncomfortable. There are a number of tests which are used, but most involve eye drops and the gentle application of pressure to your cornea.
Preparation: Remove contact lenses.
Where? An ophthalmologist or optometrist.
Test: HIV test
Why have it? Knowing your HIV status is important whether or not you are positive. If you are positive, you can take steps to leading a more healthy life and when necessary go onto antiretrovirals. You can also take steps to ensure that your partners are safe. A negative result will lead to peace of mind and hopefully the continuation of safe behaviour.
Who should have it? Anyone older than 18 (or anyone who is sexually active) should have annual HIV tests.
What does it involve? Before you can have an HIV test, you need to receive pre-test counselling and sign a consent form. Once you have received your results you will need to undergo post-test counselling.
An HIV test can take the form of a full blood test or a rapid finger prick test. In the case of a full blood test you will probably have to wait a week or two for the results, but with a finger prick tests, the results are usually available within about 20 minutes. If the first test is positive, it will need to be confirmed with a second test, as false positive readings are possible.
Because most HIV tests detect antibodies to the virus and not the virus itself, there is a window period of up to two months, during which a false negative result may be obtained. If you have had unsafe sex within three months of going for your test, you should go for another follow-up test.
Preparation: Although no physical preparation is necessary, you will need to prepare yourself psychologically for the possibility of a positive result. It may be a good idea to take a friend or family member that you trust with you for support.
Where? HIV clinics or your GP.
Women
Test: Mammogram
Why have it? Regular breast screening can detect breast cancer in its early stages and enable you to be proactive with treatment. Mammograms can detect tumours up to two years before they can be felt in a manual breast inspection. It doesn't prove that cancer is present, but it can raise suspicions that can lead to further investigations.
Who should have it? Women over the age of 35, every one to three years.
What does it involve? A mammogram is an x-ray examination of the breasts. It can be rather uncomfortable (but rarely painful) as the breasts need to be flattened between two metal plates before the x-ray is taken, so that the tissue can be properly examined. The radiation risk of damaged cells is minimal and is outweighed by the potential benefits. You should avoid having the test if you are pregnant (radiation could damage the baby) or breastfeeding (breasts that are full of milk are very difficult to examine).
Preparation: Schedule your appointment for a week after your period. Don't use any talcum powder, perfume or body lotion on the day as this might interfere with the clarity of the x-ray. Wear a shirt that you can take off easily.
Where? Gynaecologist or GP
Test: Pap smear
Why have it? A Pap smear (Papanicolaou test) — a procedure where a sample of cervical cells is collected and examined under a microscope — can detect pre-malignant and malignant cancerous abnormalities in the cells. Without the test it is impossible to detect the early stages of cervical cancer. Early detection can greatly decrease the risk of the cancer being fatal.
Who should have it?All women should have a Pap smear within three years of first becoming sexually active or by the age of 21. You should be tested every one to three years depending on your risk factors and the outcome of the test.
What does it involve? The doctor will insert a speculum to separate the walls of the cervix and will collect cells with a cotton swab or tiny spatula. The procedure will probably be uncomfortable and you might feel some cramping when the cells are being collected. The cells will then be examined under a microscope and you should get the results within a week or two.
If abnormalities are found then you might have to undergo further tests such as a colposcopy and a cervical biopsy.
A high-risk type of the human papillomavirus (HPV) is the cause of most cases of cervical cancer. A vaccine (Gardasil or Cervarix) is now available to prevent infection with the types of HPV that are most likely to cause cervical cancer.
Preparation: Schedule the test for a time when you are not having your period, preferably between 10 and 20 days after the first day of your period. In the two days before the test, take a shower instead of bathing. Don't use douches, tampons, vaginal medicines, sprays or powders and don't have sex for at least 24 hours before having the test
Where? Gynaecologist or GP
Men
Test: Prostate screening
Why have it? Prostate screening can detect the early signs of prostate cancer which would otherwise go unnoticed and greatly increases the chances of treating the cancer. Early detection of prostate abnormalities can also help you avoid the urinary problems and impotence associated with later stage diagnosis.
Who should have it? Men over the age of 50 should have annual checks.
What does it involve? In a digital rectal exam, the doctor examines your prostate by inserting a gloved, lubricated finger into your rectum. A normal prostate feels firm, if there are hard spots on your prostate, the doctor may suggest additional testing such as a Prostate-Specific Antigen (PSA) test.
The prostate produces a protein called prostate-specific antigen that can be measured in your blood. Prostate cancer (and other diseases) causes the prostate to produce larger quantities of this protein. A sample of your blood is drawn and the level of PSA is measured in a laboratory.
Preparation: Physical and sexual activity should be avoided for 24 hours before the test. Blood for a PSA test should be taken early in the morning, before eating.
Where? Urologist or GP