Diseases and their predisposing risk factors generally do not have symptoms in the early stage. Health screening aims to detect diseases in their early stages and their predisposing risk factors, so that early intervention can be started.
The common causes of mortality in Singapore include Coronary Heart Disease (CHD), Stroke and Cancers. Screening for these conditions and their predisposing risk factors are therefore highly recommended.
Screening for CHD and Stroke
CHD and Stroke occur as a result of lack of blood supply to the heart and brain respectively. This happens when the blood vessels to these organs get blocked. The risk factors that contribute to such blockage include Hypertension, Diabetes, Lipid (Cholesterol) Disorder, smoking, obesity, stress and sedentary lifestyle. Screening and early control of these risk factors therefore help to reduce one’s risk for suffering CHD and Stroke.
There are also risk factors that are beyond one’s control such as age, male sex and family history. There are also unknown factors. As such, to further assess one’s risk, an Ultrasound scan of the Carotid (neck) arteries and Cardiac Calcium Score may be useful.
Screening for Cancers
Screening for cancers should be targeted towards at risk groups as well as using the appropriate screening tests.
Colorectal Cancer is the most common cancer in men and second most common cancer in women. High risk groups include those who are 50 years old and above, and those with positive family history. The gold standard for screening for Colorectal Cancer is Colonoscopy. Besides being a screening procedure, the Colonoscopy also allows the removal of any noticeable polyp, which can potentially be a precursor of Colorectal cancer. A more common screening test for Colorectal Cancer is stool for occult blood. If noted to be positive, the next step is to proceed with Colonoscopy.
For ladies, the most common cancer is Breast Cancer. At risk groups include those who are 40 years old and above, and those with positive family history. Mammogram is recommended to be done once every 2 years for those aged above 50, and once a year for those aged 40-49. For ladies below 40 years old, regular self-breast examination is recommended.
Any lady that ever had sexual intercourse is at risk of cervical cancer. Screening for cervical cancer involves doing a Pap smear.
At risk groups for Liver Cancer include those who have chronic Hepatitis B infection and liver cirrhosis. Such individuals should have periodic blood tests for liver function and a tumour marker called alphafetoprotein (AFP). A periodic ultrasound scan of the liver is also important.