WOMEN’S HEALTH- A Paradigm Shift From Illness To Wellness
26 November 2019
For centuries women’s health has always taken a backseat. It’s second nature of women to put everyone else ahead, at their own expense. However, if women are not healthy it can affect the whole family as well as the society. It’s time we empower women to take control of their health and wellbeing. This optimal state can easily be achieved by regular health screenings and preventive care.
- What is a health screening test?
According to the WHO “screening is the process of identifying healthy people who may be at increased risk of disease or condition”
Remember the old adage, “An ounce of prevention is worth a pound of cure”. Screening tests detect hidden diseases or risk factors in otherwise healthy people much before symptoms appear so that they are effectively treated.
- What is their role in women’s health?
Screening plays an important role in women’s health as it can detect disease or risk factors when it’s most treatable and prevent serious health problems later on. According to the American Cancer Society, regular screening alone can find or even prevent about half of new cancer cases.
- What are the recommended screening tests for women?
The recommendation for screening tests varies from one person to another based on their age, overall health, habits, occupation, family history and health concerns. Hence, it’s important to get the doctor’s advice on which would be the most appropriate for that individual. Whilst health screening tests ideally should be tailored to each individual, certain tests are routinely recommended for all women. Commonly recommended cancer screening tests for women, in addition to the routine blood tests, are mammogram (breast), Pap smear (cervix) and colonoscopy (colorectal cancer), as the incidence of these cancers is very high in our population.
- At what age should women start doing their mammogram?
According to our MOH guidelines, mammograms are recommended from 50 yrs. onwards. However, in women with high risk factors earlier screening recommended. At Sri Kota Specialist Medical Centre, we have state-of -the art, 3D mammogram, as women’s health has always been our priority.
- What is the difference between a regular mammogram and a 3D mammogram?
It is basically like comparing an x ray with CT scan.
A regular mammogram is two dimensional, typically gives about four images whereas 3D mammogram is 3 dimensional and would obtain approximately 300 images. Hence, much clearer, more specific and has a better sensitivity, which means small tumors will not be missed and fewer false alarms. This is highly recommended for women with dense breasts.
- Will the mammogram results be affected by other factors – implants, hormone replacement therapy (HRT), age reconstructive surgery, etc.?
Yes. Implants can affect the interpretation of mammogram.
HRT per se does not increase risk, however because it can affect the breast density, the mammogram results may be affected.
If a nipple sparing surgery had been done, then mammogram should be done as per the recommended schedule. However, if only artificial implants like silicone are present, no mammogram needed.
It is difficult to do mammogram when Breast augmentation is done with implant. Additional views and advanced technology, like 3D mammograms may be needed for clearer image. Implants may rupture during mammogram hence its necessary to inform the radiologist prior to the procedure.
- How is cervical cancer screening done?
Screening for cervical cancer is usually done with Pap smears and HPV test. Pap test screens for abnormalities in the cells that could indicate pre or early cervical cancer.
- We know about Pap smears. But, what is an HPV test?
It’s usually done together when the Pap smear is done. It tells whether the cancer causing virus is present in the body or not. Hence, risk assessment is better.
- If a woman has had a hysterectomy, does she still need cervical cancer screening?
This will depend on the cause for hysterectomy and the type of procedure done. If the cervix had been left behind, it’s necessary to continue doing Pap as per schedule.
- What makes a good screening test? Is there such a thing as a bad screening?
A Combination of right test, disease, Patient and Treatment plan makes a good screening
Criteria for good screening:
- The condition sought should be an important health problem.
- There should be an accepted treatment for patients with a recognized disease.
- Facilities for diagnosis and treatment should be available.
- There should be a recognizable latent or early symptomatic stage.
- There should be a suitable test or examination.
- The test should be acceptable to the population.
- The natural history of the condition, including development from latent to declared disease, should be adequately understood.
- Case-finding should be a continuing process and not a “once and for all” project
- On the contrary, if screening tests are done just because they are available without following the above criteria they are bad and cause unnecessary stress for the patients and burden on health care.
- What are the potential benefits and harm of doing a cancer screening?
Preventive health screenings are an affordable and effective way to identify hidden disease risk. For many people, getting screened is the first step in early intervention to prevent potential health events later in their lives. It helps people understand their risks so that they can consult with their doctor and take the right steps towards a healthier future.
Screening tests may have harmful effects too. For example, x-ray examinations expose the body to radiation, and endoscopy of the bowel can lead to bleeding or (in rare cases) serious injuries. So it is imperative that both the benefits and harms of a screening test be assessed thoroughly by a health care professional.
- If a woman receives normal results, does this mean she is OK until her next screen?
For a majority of the women, if they follow the recommended screening schedule, they should be ok. However, risk factors are constantly evolving, hence if any unusual symptoms present they are advised to seek the attention of their health care provider, without ignoring, just because they had a health screening earlier.
So Ladies, “It’s never too early or too late to work towards the healthiest you!”
Article by: Dr. Vinodhini Bhaskara, Consultant Obstetrician and Gynecologist