Screening Tests for Women Archive

Having diagnostic tests for your heart ‘just in case' may not help you live longer or feel better, and might cause harm.

One in three American men has some form of cardiovascular disease, according to the American Heart Association. It is no surprise, then, that many men ask their doctors to run extra tests to see how healthy their hearts are. Isn't it smart to "check under the hood" from time to time for hidden danger, such as a blocked coronary artery?

Findings from a large clinical trial reported in The New England Journal of Medicine add to previous evidence that undergoing a flexible sigmoidoscopy every three to five years reduces the risk of developing colorectal cancer later in life. This is important because sigmoidoscopy is less invasive and easier to prep for than full colonoscopy, which uses a longer instrument to examine the entire colon. Some people might choose to undergo sigmoidoscopy who might otherwise avoid screening.

"Sigmoidoscopy has fewer complications, easier prep and no sedation," says Dr. William Kormos, editor in chief of Harvard Men's Health Watch. "It is reasonable start for people at average risk."

New techniques for diagnosing depression may make it easier to tell if you have the condition. They may also help change perceptions about the disorder. Two new studies indicate that depression is a physiological illness, detectable in the blood. In April, researchers at Northwestern University found they could use a blood test to diagnose depression in teenagers. A few months earlier, Harvard-affiliated researchers reported a similar finding in adults. Their blood test identified nine biomarkers associated with depression, and correctly identified people with depression 91% of the time.

"The test needs more stringent validation before it will be ready to be used in medical offices. Still, it appears that these results are promising," says Dr. Gustavo Kinrys, an instructor in psychiatry at Harvard Medical School and one of the authors of the study.

Q. During a pelvic ultrasound to evaluate uterine fibroids, a radiologist found a cyst in one of my kidneys. Should I be concerned about kidney cancer?

A. Kidney (or renal) cysts are fluid-filled sacs in the kidney that rarely cause symptoms and are usually harmless. They are quite common, and the likelihood of having one or more of them increases as we age. Cysts may be "simple" or "complex." Simple cysts are thin, round sacs with clear fluid, and they are not cancerous. Complex cysts may have thick walls, several lobes, and flecks of calcium or solid components. They are also usually benign, but need further evaluation to be sure they do not contain cancer. Most often a CT scan or MRI will help a urologist or renal expert recommend a strategy of watchful waiting, biopsy, or removal of the cyst. Occasionally, a benign cyst grows large enough to affect the function of the kidney or cause pain. A cyst may also become infected or bleed, causing fever, pain, or blood in the urine (hematuria). In that case, the cyst may need to be removed or drained.

Bowel prep is much more manageable, and CT-based ‘virtual colonoscopy' may one day allow you to skip that, too.

Public health guidelines urge people 50 or older to undergo colorectal cancer screening. There are a number of options, but the gold standard procedure is colonoscopy: using a flexible, lighted instrument to check for signs of colon cancer or the presence of potentially precancerous growths called polyps. Removing polyps can prevent cancer.

In 2008, a panel of experts, the U.S. Preventive Services Task Force (USPSTF), recommended that men 75 and older should not undergo routine PSA with the intent to screen for early-stage prostate cancer. However, men do not appear to be heeding this advice, according to a report in the Journal of the American Medical Association.

Research suggests that older men whose PSA result indicates the presence of cancerous cells in the prostate gland may be harmed more than they are helped. The cancer is not likely to progress to a life-threatening stage in the man's lifespan, but in the meantime a man faces the downsides of biopsies and treatment.

It's all in the numbers; and one model comes out the winner.

In order to prevent heart disease, you have to know who is at risk for developing it. The answer depends on whether the Framingham, Reynolds, or Adult Treatment Panel III risk scoring system is used. The three models have many similarities, but also differences in the risk factors that are included in the equation. Until recently, how the systems compared was a matter of debate.

New study highlights value of colon cancer screenings

Q. I am a healthy 52 year old who likes to stay fit. Recently, I have occasionally fainted after doing eight or 10 chin-ups. My physician did an EKG and stress test the first time this happened and found my heart is normal. He had me wear a monitor for 24 hours, and it indicated nothing was wrong. Your thoughts?

A. Someone who faints during exercise can have a serious life-threatening issue, such as narrowing of a heart valve, thickening of heart muscle (cardiomyopathy), or life-threatening arrhythmias. In your case, the chances of having a serious condition are pretty low, given the negative results of your tests.

The latest results from the European Randomized Study of Screening for Prostate Cancer (ERSPC) found a lower risk of death due to prostate cancer in men screened using the PSA test, compared to men who were not screened. But unfortunately this finding does not offer clear guidance to American men trying to figure out what the great PSA testing debate means for them.

The current definitive trial for U.S. men is the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, which involved about 77,000 men aged 55 to 74. It found no clear benefit to PSA screening, but plenty of potential harms. These included repeated biopsies, the psychological impact of a cancer diagnosis, the side effects of treatment, and overdiagnosis of potentially unimportant cancers.