What Medical Screenings Do You Need After Age 40?

Reaching the age of 40 is a significant milestone that often comes with a greater focus on health maintenance and prevention. As part of Healthy Aging Month in September, in this blog we talk to Jeffrey Cruzan, M.D., a board-certified family medicine physician with INTEGRIS Health Medical Group Memorial West, about the medical screenings to keep in mind as we get older. 

“I discuss preventive measures with my patients at every visit. It is so important and can be life saving if we can diagnose a disease at an early stage,” Cruzan says. “These studies or procedures that we recommend are relatively easy to do, most are pain free and take very little time, yet may add years to your life. I have done all preventive tests indicated for me. Speaking from experience, they are not that difficult and provide great peace of mind.” 

Why medical screenings are important 

The bottom line: Your 40s is a decade where the risk for certain conditions begins to rise. Medical screenings during this period are vital for several reasons, including early detection and slowing the progression of chronic ailments.

Medical screenings help detect diseases such as high blood pressure, high cholesterol and diabetes. 

• Sometimes, these medical conditions are present without symptoms, which heightens the need for screening.
• Identifying these issues early through screenings like blood pressure checks, cholesterol tests and diabetes screenings enables timely intervention.

Regular screenings help identify cancer or identify those who may be more at-risk of developing cancer.

• Mammograms for breast cancer, colonoscopies for colorectal cancer and pap smears for cervical cancer can detect these diseases at an early, more treatable stage.
• Early detection increases treatment success rates and survival.

Motivation for lifestyle changes can occur when patients receive health screenings.

• The results can act as a catalyst for adopting healthier lifestyle habits.
• Whether it’s improving diet, increasing physical activity or quitting smoking, screenings can motivate individuals to make changes that positively impact their health outcomes.

Health care costs are reduced over time when more people receive recommended medical screenings.

• Early screenings can prevent costly treatments for advanced diseases.
• Managing these conditions early reduces the need for expensive treatments, lowering long-term health care costs.

Types of screenings as you age

At a glance: These screenings are vital for early detection and prevention of various health conditions, helping maintain overall well-being and quality of life as you age. Always consult with your health care provider to discuss these recommendations based on your personal health history and risk factors.

Colonoscopy

A colonoscopy is recommended for everyone starting at age 45, according to the American Cancer Society.

• During the test, a doctor examines the colon with a flexible scope to identify the presence of polyps or cancer.
• If polyps are found, most people will need a follow-up colonoscopy in three years, though timing may vary based on the polyps' type, size and number.

Colorectal cancer is one of the most common types of cancer, although it’s over 90 percent treatable when caught early.

• People with a family history of colorectal cancer may need to start screenings earlier or have them more frequently.

Mammograms

Annual mammograms become the recommendation starting at age 40, according to guidelines by the American Cancer Society. 

• A mammogram is an X-ray of the breast that detects tumors or abnormalities.
• Research indicates regular mammograms help detect breast cancer earlier, reduce the need for aggressive treatments like mastectomy and chemotherapy and increase the chances of being cured.

2D and 3D mammography are both used for breast cancer screening, but they have some key differences.

• As the name suggests 3D mammography (also called tomosynthesis) produces a three-dimensional image that is clearer to help increase the detection rate.
• However, 3D mammography is more expensive and not covered by all insurance plans.

Blood pressure

Blood pressure checks should be performed each year in your 40s, as the risk of hypertension increases with age.

• Blood pressure monitoring measures systolic pressure – the pressure in your arteries when your heart beats and diastolic pressure – the pressure in your arteries when your heart is at rest between beats.
• High blood pressure is a risk factor for heart disease and stroke.

Normal blood pressure range is systolic less than 120 mmHg and diastolic less than 80 mmHg.

• Elevated blood pressure is systolic between 120-129 mmHg and diastolic less than 80 mmHg.
• Hypertension stage 1 is systolic between 130-139 mmHg or diastolic between 80-89 mmHg.
• Hypertension stage 2 is systolic 140 mmHg or higher or diastolic 90 mmHg or higher.

Cholesterol

Cholesterol tests should be conducted every four to six years in your 40s. 

• This blood test measures levels of LDL (bad cholesterol), HDL (good cholesterol) and triglycerides.
• People with a family history of heart disease may require more frequent monitoring.

LDL cholesterol should be below 100 mg/dL, as high cholesterol can lead to heart disease. 

Diabetes

Diabetes screenings are recommended every three years starting at the age of 45, but should be started even as early as 35 for people who are overweight or obese. 

• Early detection allows for lifestyle changes or medication to prevent complications. 

Diabetes or prediabetes detection can come from a fasting blood glucose test or an A1C test (reflects average blood sugar levels during the past two to three months).

• For a fasting test, 100-125 mg/dL is considered prediabetes and above 126 mg/dL is deemed diabetes.
• For an A1C test, prediabetes is 5.7 percent to 6.4 percent and diabetes is anything over 6.5 percent on two separate tests.

Prostate

Prostate screenings can begin for men starting at age 45 if at higher risk, such as due to a positive family history of prostate cancer. Generally, prostate cancer screening is recommended for men aged 55 to 70. 

• Men should discuss their individual risk factors, such as age, family history and race, with their doctor to determine the best screening approach.

There isn’t a standard screening for prostate cancer, but two types of tests – prostate-specific antigen (PSA) blood test or digital rectal exam – can help flag the presence of cancer. 

• A PSA test measures a type of protein produced by both cancerous and noncancerous tissue in the prostate.
• Elevated PSA levels range from 4.0 to 10.0 ng/mL, which indicates a higher risk of prostate cancer.
• Higher levels above 10.0 ng/mL increase the likelihood of prostate cancer, but further testing, such as a biopsy, is often needed to confirm a diagnosis.
  
  

Wellness exams

Annual wellness exams are important for anyone over the age of 40.

• In addition to monitoring blood pressure levels, wellness visits are also important to screen for mental health issues such as depression or anxiety and to help monitor weight-related issues such as obesity.

For more information about screenings, contact your primary care physician or call one of the INTEGRIS Health primary care clinics in your area.