Dr. John Feightner, chair of the Canadian Task Force on Preventive Health Care and a professor in the department of family medicine at The University of Western Ontario in London, Ont., explains that there is fair consensus on the benefits of many tests. For others, controversy still exists; people need to discuss pros and cons with their doctors.

Here are tests that most adults can expect to have. Follow the schedule, and one of them could save your life. A number of tests, such as the blood pressure test, the Pap smear and the breast exam, will be part of your regular physical.

1. Blood pressure exam This one’s not so bad. The doctor puts a blood pressure cuff around your upper arm and inflates it to check systolic pressure (when the heart contracts) and diastolic pressure (when the heart relaxes). He can use the test to identify the 15 per cent of the adult population that suffers from hypertension, a leading cause of heart attacks and strokes and recommend treatment.
It’s part of the regular physical, and most doctors will check your blood pressure every time you visit the office.

2. Stool test, sigmoidoscopy These tests may uncover bowel, colon and rectal cancer, which can often be symptomless. The occult blood in the stool test necessitates a special diet for two days, then a stool sample collection, which is tested chemically for the presence of blood. The sigmoidoscopy uses flexible, light- or camera-bearing tubes to examine the descending colon and rectum. Another available test is a colonoscopy, which can view the colon more extensively than a sigmoidoscopy.

People who are 50 and over should have a stool test every 12 to 24 months. For the sigmoidoscopy, consult your doctor about having it every five years, especially if you have a family history of bowel or colon cancer. Some experts suggest a coloscopy every 10 years may be an effective screening strategy.

3. Booster shots, immunizations With a single booster shot, you can renew your immunity to tetanus, diphtheria and polio. Diphtheria is caused by a bacteria that can cause potentially lethal heart and neurological problems. Tetanus results if bacteria from soil, rust, dust or animal feces enter open wounds in people who are not immunized. Of the reported cases of tetanus, 30 per cent are fatal. Poliomyelitis is extremely rare in Canada thanks to widespread immunization, but it remains common in other parts of the world. It is caused by a virus that enters via the mouth and can produce permanent paralysis by damaging spinal-cord nerve cells.

Everyone should get a booster every 10 years to renew the effectiveness of the vaccine. Women should not be immunized while pregnant.
With three injections spaced out over several months, your doctor will immunize you against hepatitis B, one of the most common forms of hepatitis. This serious and sometimes fatal form of liver disease is passed on mainly by sexual contact, infected blood products, dirty injection needles and shared household items such as toothbrushes, nail clippers or razors.

All sexually active women and men, as well as all health-care workers and military personnel, should be immunized against hep B. Most school boards immunize students in Grade 7.

Everyone who is over 65 – or who lives in a chronic-care facility or who has a chronic condition such as bronchitis, emphysema or heart disease – should get an annual flu shot. Routine flu vaccination in healthy adults is also effective in reducing rates of infection and absenteeism.

4. Sexually transmitted diseases test The test for gonorrhea is a Gram stain and a culture of a cervical or urethral smear; for chlamydia, it’s a cervical swab or urine sample. Syphilis, hepatitis B and HIV are diagnosed through blood tests. If you are between 15 and 24, have been sexually active with more than one partner in the last year and live in an urban area, you are at highest risk for a sexually transmitted disease. But there are other times to consider testing:

• if you know or suspect your sex partner is infected or has a previous history of STDs;
  
• two months after entering into a new sexual relationship;
  
• if you’re an intravenous drug user or if your partner is an intravenous drug user;
  
• if there are signs of an unusual discharge from the penis or vagina, rash, warty growths, pimples, itchiness or sores on the genitals, pain when urinating, persistent lower abdominal pain;
  
• if women experience changes in menstrual flow;
  
• if women are pregnant or are planning pregnancy.

5. Eye Exam The doctor looks at your eyes and assesses your ability to read the Snellen Chart, with the big E at the top and increasingly small letters below. He’s testing for farsightedness and nearsightedness, for cataracts, dry eyes and irregularities. If a woman is pregnant, an eye doctor also looks for hemorrhaging, which could be a sign of toxemia or diabetes. He tests for glaucoma, a disease usually marked by increased pressure in the eyeball using a tonometer which measures the internal pressure of the eye. For presbyopia, a condition beginning in middle age whereby the lens of the eye loses its flexibility to focus close-up, he checks the prescription required to read.

Everyone needs an eye exam every two years (annually if you have corrective lenses); people with diabetes should get a dilated exam annually; and everyone needs glaucoma and presbyopia testing annually once they turn 40.

6. Dental checkup The dentist examines and cleans your teeth, looks at your gums, gives you advice on oral health including dental hygiene (regular brushing and flossing) and takes X-rays if necessary. Dental decay is one of the most prevalent infectious diseases, and heart disease has now been linked to periodontal (gum) infections. Dentists can also discover mouth cancer.

Most people should have a dental checkup every six months.

7. Digital rectal exam A physician’s gloved finger through the rectum probes for nodules and lumps that could prove to be colon or prostate cancer which continues to be the second leading cause of cancer deaths in Canadian men.

Men and women 50 and up should have this test as part of a periodic checkup; those in high-risk groups, earlier.

8. PSA testing A blood test to try to identify prostate cancer, its overall benefits have not yet been established. It is important for men between the ages of 50 to 70 to discuss with their physician the risks and benefits that might follow testing.

9. Breast exam The physician manually examines your breasts, armpits and nipples or signs of lumps and unusual tissue and nipple discharge. Breast cancer is a second leading cause of cancer death in women and affects approximately one woman in 10 during a normal lifespan.

Every woman should have it annually and perform monthly breast exams on herself.

10. Mammogram A machine takes X-rays of your breast from various angles to check for cancer. In women over 50, mammography reduces the breast-cancer mortality rate by 30 per cent.

Every woman aged 50 and over – and women of any age if they have a mother or sister who had breast cancer – should have a mammogram every two years. For best results it should happen in the first two weeks of a woman’s menstrual cycle.

11. Pap smear The doctor inserts an instrument into the vagina and scrapes a few cells from the cervix for examination. The main reason 400 Canadian women per year die of cervical cancer is that they haven’t had regular Pap tests. If caught early enough, cervical cancer can be completely cured without the invasive procedures associated with other forms of cancer.

All sexually active women and/or women 18 to 69 should have this test once a year. If the test comes back normal three years in a row, you can have it done at longer intervals (at your – or your doctor’s – discretion).

A personal note It’s wise to keep track of all your test results and medical history. Many adults are oblivious to when they had their last tetanus vaccines or whether they had chickenpox as children. Take note of all this (electronically or otherwise) while it’s fresh in your brain. Also, make a record of your kids’ shots and dental visits. For some guidance in putting this together, visit www.yourownhealth.com This interactive personal heath site features a Personal Health Notebook. You can register and use it online to create and edit records of your health conditions, allergies, immunizations, medications and more. Risks If you have a family history of certain diseases, or if your lifestyle puts you at risk, you might be a candidate for other tests that don’t apply to the general population. Blood-sugar testing According to the Canadian Diabetes Association, if you are over 45 you may want to get your blood-sugar levels checked every three years. However, if you have risk factors associated with diabetes, you may want to get your blood-sugar levels checked at an earlier age, and more often. Cholesterol testing If you’re between the ages of 30 to 59 or you have a family history of heart disease, are overweight, smoke or have a poor diet, you should discuss with your doctor about getting a blood test to check your cholesterol levels. Checking for melanoma If a close relative has had the deadly form of skin cancer known as melanoma, you should keep a close watch on your moles. Visit your doctor for a skin check and ask your partner to help you check for changes to the colour, size and shape of your moles. Breast self-exams Do a breast self-exam monthly. Many lumps are discovered by women themselves. The best time is within the first week or so after your period when your breasts are least tender. If you don’t menstruate, pick the same day each month. The circle method Examine the breast in concentric circles starting at the outside edge of the breast and working in to the nipple. Use your three middle fingers in a rotary motion, feeling with your finger pads (not tips). Include the area between the breast and the armpit, which also contains breast tissue. Follow this accepted method both standing up and lying down, as outlined below. 1- Standing up Raise one arm. Use your right hand to examine your left breast and your left hand to examine your right breast. With fingers flat, touch every part of each breast, gently feeling for a lump or thickening. 2- Lying down To balance the breast on the chest, place a towel or pillow under your right shoulder and place your right hand behind your head. Examine your right breast with your left hand. Repeat on the other side. 3- In the mirror Do a visual check of your breasts with arms at your sides, then raised above your head. Look carefully for changes in size, shape and contour of each breast, as well as changes in the nipple such as puckering, dimpling, or changes in skin texture, colour, rashes or nipple discharge. For a booklet on breast self-examination, contact the Canadian Cancer Society’s Cancer Information Service, 1-888-939-3333.