Annual physical examinations on time not only reflect the current health status, but also help in the early detection of diseases. However, most of the current medical checkup packages are one-sided and measure the most routine items.
Physical examination experts remind, for patients with chronic diseases, especially people over 40 years old, annual physical examination alone is far from enough, should be added to do some targeted examination, which is very critical for the early detection of disease, early prevention, but also directly related to the quality of life in the future.
Screening cardiovascular disease, just do electrocardiogram is far from enough
Over 40 years old, cardiac ultrasound and carotid ultrasound should be added
The cardiovascular system in the human body is like the engine and oil circuit of a car. Once something goes wrong, the consequences are ultimately fatal, so reducing the occurrence of cardiovascular and cerebrovascular accidents is an important goal of chronic disease management. For people over 40 years old, with a family history of cardiovascular disease, or combined with diabetes, hypertension and hyperlipidemia, it is not enough to check only an electrocardiogram and measure the heart rate during the annual physical examination, it is recommended to have “two ultrasounds and one CT”, i.e. cardiac ultrasound, carotid ultrasound, and cardiac CT, especially for people with high blood lipid, high blood pressure, and occasional chest tightness and pain. People who have occasional chest tightness and chest pain.
”Many patients with acute coronary syndrome, although they have developed coronary atherosclerosis, still feel well, and the blood lipids, blood pressure and ECG of the routine physical examination are still normal, because the sclerotic plaque is smooth when it is not ruptured, which does not affect the operation of blood. The cardiac ultrasound can look at the size of the heart, any thickening of the ventricular wall and the presence of plaque for early detection and early intervention. Carotid ultrasound can monitor the formation of plaque in the vessel wall.” Experts say the main role of cardiac CT is to determine whether there are blockages and stenoses in the heart vessels, which helps to take targeted measures as early as possible.
People over 40 years old with hypertension
Add a test for glycated hemoglobin
Experts remind that people over 40 years old who have hypertension but have not yet been diagnosed with diabetes and have normal fasting blood sugar are advised to have an additional glycosylated hemoglobin. It is clinically found that about 60% of this group may have combined abnormal glucose metabolism, but their fasting blood sugar is mostly normal, in fact, they belong to potential patients with diabetes. Glycosylated hemoglobin can reflect the post-prandial blood glucose of the examiner and the control of blood glucose in the past two or three months. If the test result is abnormal, it is recommended to consult a specialist in time to prevent the progression to a real diabetic, thus increasing the risk of cardiovascular accidents.
Don’t refuse urine test for people over 40 years old
When doing ultrasound of liver, gallbladder, spleen and pancreas, add both kidneys
”Bladder cancer, kidney cancer and prostate cancer are the three most common tumors of the urinary system, especially kidney cancer, our hospital used to do not even a few units a year, but now there are almost six or seven units a month. If kidney cancer can be detected early, the 5-year survival rate is very high. But kidney cancer often has no symptoms in the early stage, and when pain and blood in urine appear and then rushed to the hospital, most of them are not very early anymore.” Experts said, “Once a year urine test and kidney ultrasound can help detect kidney cancer at an early stage, urine test is usually included in medical checkup packages, people should never be afraid of trouble and must do it, while kidney ultrasound may not be available in all packages, but this test is very convenient, just add one when doing liver, gallbladder, spleen and pancreas, although it is done incidentally, it is very meaningful, especially for people 40 people over the age of 40.”
Experts recommend that middle-aged and elderly people (especially those over 50) take urine tests seriously also because they can detect microscopic hematuria (hematuria invisible to the naked eye), and once such people have microscopic hematuria, or intermittent, painless hematuria visible to the naked eye, one or two out of 50 people will have a urinary tract tumor (bladder cancer, kidney cancer, ureteral cancer, etc.).
”There are various clinical arguments for screening for prostate cancer, ranging from over 40 years old to over 45 years old. My recommendation is to screen at age 40 if two or more people in the family have prostate cancer. If one person in your family has prostate cancer, you can postpone starting screening until age 45. over age 50, you should be screened for prostate cancer whether or not there is a family history. Screening methods include ultrasound of the prostate, PSA index test, and rectal examination. As long as you can adhere to the screening, it is usually not too late even if detected.”
Breast ultrasound for women over 18 years old once a year
Add a mammogram X-ray every 2-3 years above 40 years old
The current clinical screening for breast cancer is divided into three major steps: self-examination + breast ultrasound + mammography. In the medical checkup package, the simplest one is hand palpation, i.e. the surgeon determines whether there is a lump in the breast and whether there is a depression in the skin through palpation and observation. This has some limitations and is very much related to the surgeon’s experience.
It is recommended that adult women (18 years old and above) add a breast ultrasound to their annual physical examination. after 40 years old, especially 50 years old, which is the age of high incidence of breast cancer, it is recommended to add a mammogram, which will also detect tumors that do not manifest as lumps, but only as calcifications, and is more sensitive than B ultrasound. If there is no problem and no family history, it can be done once every 2-3 years, not every year, after all, mammogram has rays and it is not good for the body to do it frequently.
Do a colonoscopy after 40 years old
Gastroscopy should be done once a year from the age of 40 to 75
China is a country with high incidence of stomach and intestinal cancer, and stomach and intestinal cancer is also one of the most common tumors in medical checkups, second only to lung cancer. At present, there is no unified guideline for stomach cancer screening in China. In the routine physical examination package, stool occult blood test is one of the means to screen for stomach cancer, but for some stomach tumors, by the time the occult blood test is positive, it may not be early anymore.
”I recommend that people between the ages of 40 and 75 have an annual gastroscopy. This group is a high-risk group for gastric cancer, accounting for about 80-90 percent of gastric cancer patients. Especially patients suffering from chronic atrophic gastritis, gastric polyps, and gastric mucosal intestinalization.”
Experts also said that once a person reaches the age of 40, he or she should have a colonoscopy to screen for bowel cancer, which is now a common international guideline.
”If the result shows negative, there is no discomfort later, and the person does not belong to a high-risk group, he or she can have another one in three to five years. If you are in a high-risk group, you should do the relevant tests under the guidance of your doctor. If polyps and ulcers are detected in the first year, you should go to a specialist for review first, and if there is no abnormality in the review, the problem is not serious, but you have to do colonoscopy in the second year, and it should be done for two consecutive years, and only if there is no problem in two consecutive years, you can set the next review time under the guidance of a specialist.”
Experts remind that those who have family history of colorectal cancer or other tumors, smoking, overweight, gallbladder removal for more than 10 years, and chronic constipation history for more than 2 months per year in the past two years should go to hospital for diagnosis in time if they suddenly have symptoms such as blood in stool, change of stool habit, and sense of incomplete defecation, which may be signals of intestinal cancer.
Myopia over 600 degrees, diabetic patients
or over 50 years old should have their eye pressure measured annually
”The eye examination in the physical examination, in addition to looking at the visual acuity, the ophthalmologist will also observe whether there is arteriosclerosis in the fundus of the examinee, whether the optic nerve is sunken and enlarged, whether there is trachoma, cornea and other problems, so this examination cannot be ignored.” Specialists say, “Special groups of people should also have their eye pressure measured once a year to help prevent glaucoma. Myopia more than 600 degrees, after the age of 25 myopia is still deepening; have diabetes; family history of glaucoma; have done laser myopia correction, vision regression, these people are the target group of glaucoma, it is recommended to test the eye pressure once a year; after 50 years old, regardless of the above problems, should be measured once a year. The eye pressure measurement is also very cheap, as long as a few dozen dollars, and no harm to the body.”
Experts also reminded that if you close your eyes and find that the eyeball is hard, or have a sense of pressure and pain, you may have high intraocular pressure, you should promptly go to the ophthalmology department to take a look, but not necessarily glaucoma, may be high intraocular pressure disease.
Frequent smokers, three high people
Additional annual examination of the ankle-brachial index
”Over 60 years old, smokers, or those with diabetes, hypertension, and hyperlipidemia, as long as one of the above factors is met, it is best to check the ankle-brachial index (ABI) during the annual physical examination. By measuring the systolic pressure of the posterior tibial or anterior tibial artery and the brachial artery in the ankle, the ratio between the arterial pressure in the ankle and the brachial artery pressure is obtained, which helps to detect atherosclerosis in the lower extremities at an early stage. The range of ankle-brachial index for normal people at rest is 0.9-1.3, below 0.9 is abnormal, and it is important to consult a specialist clinic promptly, even if there are usually no symptoms.” Experts say that lower extremity atherosclerosis, if left untreated, develops to an advanced stage and may require amputation.
After the age of 45 for women and 50-55 for men
Check bone density once a year
Fracture is a common disease in the elderly, said Dr. Fang Lizheng, director of the Department of Family Medicine and Health Promotion Center of Run Run Run Shaw Hospital, Zhejiang University School of Medicine, and elderly fractures are mostly related to the loss of calcium in the bones, clinically known as osteoporosis. It is recommended to check bone density annually after the age of 45 for women and after the age of 50-55 for men to take early measures to reduce the incidence of osteoporotic fractures.
After the age of 40
Have annual low-dose spiral CT of the chest
Lung cancer is currently the cancer with the highest incidence and mortality rate in China, and it is also the most commonly seen cancer in medical checkups. Nowadays, chest X-ray is included in the medical check-up package. Although X-rays can also screen for some lung diseases (including lung cancer), they are less sensitive and cannot screen for lung cancer in many areas.
In contrast, low-dose spiral CT of the chest is more sensitive for lung cancer screening. Although there is controversy in the medical community about whether to include low-dose spiral CT in the annual screening program, most scholars believe that it is necessary. Currently, low-dose spiral CT of the chest is widely used for lung cancer screening in Japan and the United States.
”I recommend that people over the age of 40 be able to have one once a year. Especially those who smoke frequently, have a long history of smoking, are addicted to smoking, and those who work in dust and other related occupations.” The expert said.