Hello, my friend!

Happy September!

If you're like me, you're thoroughly enjoying the cooler nights and clearer air!

This month, I outline the recommended screening assessments based on your age and health status (as outlined below). You may wish to save this email as a resource going forward.

I've noticed that many of my patients are not aware that they should be getting regular screening tests. Doctors should offer these during primary care visits but someone who doesn't see their doctor might miss out.

These screening guidelines are prevention in action.

These screening exams help detect problems early when they are easier to treat. And best of all, these exams come at no cost to you (in BC anyway) if ordered by an MD.

The recommendations below are BC-specific. Recommendations may vary slightly depending on your state or province.

Are you up to date on your screening exams for blood pressure, diabetes, cholesterol, and even cancer?

Jump ahead to your decade and notice if you're up to date or if you are due for assessment.

Quick note before we get going:

While there aren't standard guidelines, it is recommended to also check in on mental health routinely. I invite any existing patients who haven't had a mental health assessment in 2+ years to reply to this email and I will send you two brief mood questionnaire to complete––free of charge.

One more quick note:

When diabetes and cholesterol screening is listed as "optional based on risk factors", the risk factors are:

Higher body weight: A body mass index (BMI) of 25 or higher (or 23 or higher for Asian American/Asian Canadian individuals).
Family history: A parent or sibling with type 2 diabetes.
Pregnancy history: A past diagnosis of gestational diabetes or delivering a baby weighing over 9 pounds (4 kilograms).
Hormonal conditions: A diagnosis of polyendocrine metabolic ovarian syndrome (PMOS).
High blood pressure or cholesterol: High blood pressure readings or abnormal blood fat levels.
Ethnic background: Belonging to a higher-risk population, such as Indigenous, South Asian, Asian, Black, or Hispanic heritage

If you're in your 30s...

Applicable to both biological males and females:

Blood pressure monitoring - annually
Sexually transmitted infection (STI) testing - any time there is a new sexual partner or every 3-6 months if you have multiple partners
Mental health screening: anxiety & depression - during office visits

Optional for males and females:

Diabetes screening - if risk factors present
Cholesterol screening - if risk factors present

Females only:

Cervical cancer screening (HPV testing) - every 5 years
Mammogram (breast exam) - annually - only if you have a strong family history of breast cancer or BRCA gene positive

Males only:

Testicular self-exams: Check testicles monthly for unusual lumps, swelling, or pain, and report changes to a doctor.

If you're in your 40s...

Applicable to both biological males and females:

Blood pressure monitoring - annually
Testing for sexually transmitted infections - any time there is a new sexual partner or every 3-6 months if you have multiple partners
Cholesterol screening - every 5 years
Diabetes screening - every 3 years
Mental health screening: anxiety & depression

Females only:

Cervical cancer screening (HPV testing) - every 5 years
Mammogram (breast exam) - every 2 years or annually if you have a strong family history of breast cancer or BRCA gene positive. Can self-refer through the BC Cancer Screening Mammography Program.

Males only:

Testicular self-exams: Check testicles monthly for unusual lumps, swelling, or pain, and report changes to a doctor.

Males - Optional:

Prostate Cancer Screening: Routine screening using a PSA blood test is not universally recommended or routinely covered for average-risk men at 40, but you should discuss your individual risk factors and family history with your doctor.

If you're in your 50s...

Applicable to both biological males and females:

Blood pressure monitoring - annually
Testing for sexually transmitted infections - any time there is a new sexual partner or every 3-6 months if you have multiple partners
Cholesterol screening - every 5 years
Diabetes screening - every 3 years
Colorectal cancer screening - every 2 years - home stool test (Fecal Immunochemical Test or FIT kit) through BC’s Colon Screening Program.
Mental health screening: anxiety & depression

Females only:

Cervical cancer screening (HPV testing) - every 5 years
Mammogram (breast exam) - every 2 years or annually if you have a strong family history of breast cancer or BRCA gene positive. Can self-refer through the BC Cancer Screening Mammography Program.

Males only:

Testicular self-exams: Check testicles monthly for unusual lumps, swelling, or pain, and report changes to a doctor.

Males - optional:

Prostate Cancer: Routine screening using a PSA blood test is not universally recommended or routinely covered for average-risk men at 50, but you should discuss your individual risk factors and family history with your doctor.

Optional for males and females:

Bone scan / Osteoporosis screening: consider if risk factors present

Osteoporosis risk factors - one or more of:

Fragility fractures after age 40
High-risk medication use (3+ months steroid use, aromatase inhibitors, androgen deprivation therapy)
Rheumatoid arthritis
Other chronic inflammatory conditions
Cushing’s disease
Malabsorption syndrome
Uncontrolled hyperthyroidism
Primary hyperparathyroidism
Hypogonadism; Early menopause (< 45)
Other disorders associated with rapid bone loss/fractures
Lifestyle factors such as current smoking or heavy alcohol use (3+ drinks daily)
Low BMI (BMI < 20 kg/m2)
Family history of a parent who fractured a hip
Celiac disease

If you're in your 60s...

Applicable to both biological males and females:

Blood pressure monitoring - annually
Testing for sexually transmitted infections - any time there is a new sexual partner or every 3-6 months if you have multiple partners
Cholesterol screening - every 5 years
Diabetes screening - every 3 years
Colorectal cancer screening - every 2 years - home stool test (Fecal Immunochemical Test or FIT kit) through BC’s Colon Screening Program.
Bone scan / Osteoporosis screening: Women: every 3-10 years starting at age 65; Men: only if risk factors present
Mental health screening: anxiety & depression

Females only:

Cervical cancer screening (HPV testing) - every 3-5 years (if sexually active)
Mammogram (breast exam) - every 2 years or annually if you have a strong family history of breast cancer or BRCA gene positive. Can self-refer through the BC Cancer Screening Mammography Program.

Males only:

Testicular self-exams: Check testicles monthly for unusual lumps, swelling, or pain, and report changes to a doctor.

Males - Optional:

Prostate cancer screening: Routine screening using a PSA blood test is not universally recommended or routinely covered for average-risk men at 60, but you should discuss your individual risk factors and family history with your doctor.

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If you're in your 70s...

Applicable to both biological males and females:

Blood pressure monitoring - annually
Testing for sexually transmitted infections - any time there is a new sexual partner or every 3-6 months if you have multiple partners
Cholesterol screening - every 5 years
Diabetes screening - every 3 years
Colorectal cancer screening - every 2 years until age 74 - home stool test (Fecal Immunochemical Test or FIT kit) through BC’s Colon Screening Program.
Bone scan / Osteoporosis screening: every 3-10 years
Mental health screening: anxiety & depression

Females only:

Cervical cancer screening (HPV testing) - every 3-5 years - only if history of abnormal tests
Mammogram (breast exam) - every 2 years up until age 74 or annually if you have a strong family history of breast cancer or BRCA gene positive. Can self-refer through the BC Cancer Screening Mammography Program.

Males only:

Testicular self-exams: Check testicles monthly for unusual lumps, swelling, or pain, and report changes to a doctor.

Additional / Targeted Screening:

These assessments are only done in specific situations, as outlined:

Lung Cancer: Annual low-dose CT screening is recommended for high-risk current or former smokers (aged 55 to 74 with a heavy smoking history) via BC Cancer's Lung Cancer Screening Program.

Abdominal Aortic Aneurysm (AAA): A one-time ultrasound screening is typically considered for men aged 65 to 80 who have a history of smoking.

Prostate Cancer (PSA): Routine screening using a Prostate-Specific Antigen blood test is not universally covered by BC MSP as a blanket public program, but you can discuss individual risk-based testing with your doctor.

PSA is generally private pay unless symptoms or risk factors present:

Urinary tract symptoms (urinary frequency / difficulty)
When prostate cancer suspected (ex. Mass)
Personal history of prostate cancer
Strong family history of prostate cancer or certain genetic risk factors

Digital rectal exam (prostate exam): not recommended as a routine exam. This physical exam is only recommended for men who are symptomatic or as follow-up to an abnormal PSA blood test.

Additional information:

Cervical cancer screening:

Self-collect kits are free and available for women age 25-69. These can be ordered here and shipped to your door.

Breast cancer / mammogram screening:

Women age 40-74 can self-refer for a mammogram. Phone 1-800- 663-9203 to book an appointment.

Can naturopathic doctors do any of this?

Yes! NDs can do all of the following, but these are private pay:

Blood pressure checks
Diabetes screening
Cholesterol testing
Prostate antigen blood test
FIT test (colon cancer screen)
Refer for bone scan (private pay)
Sexually transmitted infections testing
Cervical cancer HPV screening (or pap tests in office, depending on provider)
Mental health screening exams
In-office breast exam
In-office testicular exam
In-office prostate exam (digital rectal exam)

Naturopathic doctors in BC can not refer for a DEXA scan, CT scan, or ultrasound.

So? How are you doing? Are you up to date? Are you overdue in your screening tests? If you're up to date, well done! There are even more blood tests that can be done in the name of prevention!

If you prefer a proactive approach and prefer to work with me for these (and possibly even more detailed) preventive strategies, feel free to book an appointment.

That's all for this month! See you again in October :)

What did you think of this newsletter? Was it helpful? Comments? Questions? Just reply to this email! I'd love to hear what you think!