"Keeping on track with your health should start with you. Establishing good health habits as early in life as possible means that you may enjoy a longer, healthier, happier life. And by getting the right health checks at the right time, you can work with your health care team to make sure you find and, if possible, prevent the effects of any health problems that you might encounter throughout the different stages of your life."
Dr Christine Bennett
Chair, Medical Advisory Panel, Bupa Australia.
What is a health check?
A health check is an examination of your current state of health, usually carried out by your GP. From the moment we are born, and even before, we undergo a variety of tests to ensure we are on the right track to good health. As we get older, many of us become more vulnerable to illness. In order to reduce this risk, a number of health checks or screening tests are recommended for different stages of our lives.
Why is a health check important?
The aim of a health check is to help find, prevent or lessen the effect of disease. It's sort of like getting your car serviced before it breaks down - after all, it's better to avoid disease altogether than to treat it. Although some checks can be uncomfortable, they provide your doctor or specialist with an opportunity to look at your lifestyle, medical history and family history to find out if you're at risk.
Having a regular doctor or practice for all your health checks has several advantages. Most importantly, you will build a relationship over time and are more likely to feel comfortable talking openly. Also, your doctor will get to know you and understand your health needs and concerns. By having a regular doctor or practice, your medical history stays in the one place, and is more likely to be kept up to date.
What does a health check usually involve?
A health check will generally involve:
- Updating your medical history and examining your health issues
- Performing tests if required
- A follow up of any problems identified
- Advice and information on how to improve your health.
What regular health checks should we have at different life stages?
There are a number of health checks recommended for different stages of life. Click below to see what health checks we should have and why.
Health checks for pre-conception & pregnancy
Pregnancy is a major life event and places many demands on a woman's body. The preconception period is generally considered to be the three months prior to pregnancy. This is an ideal time to undergo a health check as making changes to one's life at this time can help reduce problems during pregnancy and assist in recovery from birth.(1) According to the NSW Medications in Pregnancy & Breastfeeding Service from the Royal Women's Hospital, important health checks before pregnancy include:
Carried out by: GP or gynaecologist
Why: This test is recommended every two years, or more frequently for some people, to detect changes to cells in the cervix before they develop into cervical cancer. The cervical cancer vaccine does not replace the need for a pap test because the vaccine does not protect you against all cancer-causing types of the human papilloma virus. Because of the nature of the Pap test, you may prefer to have this done before you're pregnant, or you may be offered a test in early pregnancy.
Carried out by: Dentist or oral hygienist
Why: Poor dental health can affect not only our teeth and gums bu also lead to problems like malnutrition and infections in other parts of our bodies. Regular annual dental check-ups are therefore important. But, X-rays are not recommended during pregnancy so having a dental check before you're pregnant is a good idea.
Carried out by:Arranged by your GP
Why: When planning a pregnancy, you should know your vaccination status and immunity. A simple blood test can reveal whether you've had immunisations and are immune to infections that may be harmful to a pregnancy such as rubella, varicella (chicken pox) and influenza.
- General health and blood tests
Carried out by: Arranged by your GP
Why: Your general health is important to assess since any problems may be resolved before falling pregnant. You may have blood tests to check for thyroid function, blood sugar levels, sexually transmitted infections (STIs) and a full blood count to check your iron and folate levels. Your doctor can help you determine what checks might be right for you.
Pregnancy is a major life event and places many demands on a woman's body. Several different health checks may be available to you during pregnancy, including abdominal palpitations, ultrasounds, maternal serum screening test (MSS) and amniocentesis just to name a few. Make sure to check with your doctor or gynaecologist on which tests you might need.
Health checks for newborns and children
Australian guidelines recommend health checks at birth, 1-4 weeks, 6-8 weeks, 6-8 months, 18 months, 2½ -3½ years and 4-5 years. These regular visits to your doctor give you an opportunity to raise and discuss any aspects of caring for your child and your child's health and development.
Every newborn in Australia is offered a blood test to check for the presence of particular metabolic or genetic disorders including phenylketonuria (PKU), hypothyroidism and cystic fibrosis. A newborn's height, weight and head circumference are also measured.
Regular health and development checks are recommended for all young children to ensure that they are growing and developing normally, and to manage any health problems early on. These checks can be carried out by a doctor or a community child health nurse. As children grow older, health checks may involve assessing their:
- hearing, vision
- fine motor skills
- language
- social skills
- family dynamics
- nutrition
- physical activity
Immunisation from an early age is highly recommended for all Australian children, as it offers protection against the most serious childhood infections. The National Immunisation Program provides information on the routine childhood immunisations recommended for children in Australia, and the schedule coincides with routine childhood health check guidelines.
Health checks in your 20s and 30s
Health checks in your 20s and 30s(Ref 8-12)
Many young people find it difficult to access health care, and once they have, to raise important health care issues with their doctor. You're in the prime of your life and the last thing on your mind is health problems. That is exactly why health checks are so important. Important health checks at this stage of your life include:
Carried out by: GP
Frequency: At least every two years.
Why: High blood pressure has no symptoms. It's a major risk factor for stroke, heart disease and heart failure. If the heart has to pump against a higher pressure over many years it can lead to weakness of the wall of the heart. High blood pressure can also lead to eye and kidney damage.
- Cholesterol and glucose levels
Carried out by: GP
Frequency: Every two to five years.
Why: High blood levels of cholesterol and/or glucose contribute to your risk of developing heart disease and type 2 diabetes. Particularly as you reach the second half of your thirties, the effects of unhealthy behaviours such as smoking and poor diet can start to show. If you're overweight, have polycystic ovary syndrome or have a family history of heart disease or type 2 diabetes, you should have your cholesterol and blood sugar levels checked more frequently. A total cholesterol of under 5.5 mmol/L is ideal.
- Pap smears & pelvic exams
Carried out by: GP
Frequency: Every two years or more frequently if your doctor advises because of previous abnormalities or conditions.
Why: Women over the age of 18 who have ever had sex should have regular pap tests. This test detects changes to cells in the cervix before they develop into cervical cancer. The cervical cancer vaccine does not replace the need for a pap test because the vaccine does not protect you against all cancer-causing types of the human papilloma virus. A pelvic examination can detect abnormalities in the ovaries and uterus. Your early 20s is a good time to find a gynaecologist you like and stick with them.
- Dental check and cleaning
Carried out by: Dentist or oral hygienist
Frequency: Every twelve months.
Why: We all know that we should floss, brush twice a day and limit sugary foods. But did you know that poor dental health can affect not only our teeth and gums but also lead to problems like malnutrition and infections in other parts of our bodies? This is why regular preventative dental check-ups are important. See your dentist as soon as possible if you have a toothache, bleeding gums or dental trauma and make sure to book in your annual check-ups.
Carried out by: GP or dermatologist
Frequency: Self check for 15 minutes every month and annually with a doctor.
Why: Ninety-five per cent of skin cancers are treatable if they are detected early. Regular checks of your skin should detect any suspicious lumps or spots as early as possible and you're more likely to notice any changes if you get to know your skin. Pay particular attention to your arms, legs, face, back, neck, shoulders and backs of your hands and see your doctor if there are any changes.
- Sexually transmitted infections (STI) screenings
Carried out by: Arranged by your GP
Frequency: Depends on how sexually active you're and whether you use condoms consistently.
Why: STIs can be passed during vaginal, anal or oral sex. Some STIs can be passed from a pregnant woman to her baby or during the baby's birth. It's recommended you get tested after unprotected sex with a new partner or if your partner has had other sexual partners. And, your sexual partner should also be tested. For men who have sex with other men, it's important that you're checked at least every year. Many STIs can be easily treated with antibiotics but ignoring them can cause serious health problems, such as infertility.
Carried out by: GP and you can do regular self checks
Frequency: All men should check their testicles regularly, around every four weeks. It's particularly recommended for men who are at higher risk of testicular cancer, those who had undescended testicles at birth or are infertile.
Why: If found and treated early, testicular cancer has a high cure rate, so it's important for men of all ages to self-examine regularly for any unusual lumps or swellings. The test is quick and simple, using your fingers and thumb to feel the testes, one at a time. Not all lumps or swellings will be cancer but if you notice something unusual or have any concerns, you should get your doctor to check it out right away.
- Waist circumference and weight assessment
Carried out by: GP
Frequency: At least every two years.
Why: A healthy body mass index (BMI) can help reduce the risk of many chronic diseases including type 2 diabetes, heart disease and osteoporosis. The BMI is an estimate of your total amount of body fat, by looking at the ratio of your weight to your height. A BMI of 20–25 is considered healthy for most young and middle-aged adults. However, BMI calculations can be inaccurate in certain populations such as high performance athletes, pregnant women, and the elderly, so consult your doctor about what weight range is healthy for you. Waist circumference measurements have been shown to give a more accurate indicator of health risk than BMI alone. Regardless of your height and build, excess fat around your waist can increase the risk that you will develop a chronic disease. For most people, a waist measurement greater than 94cm for men and 80cm for women puts them at increased risk. If you're already at a moderate risk developing heart disease you should have your waist circumference and weight checked more frequently at every six to 12 months.
Health checks in your 40s
In your 40s, you may be distracted by career and/or family but it's an important time not to neglect your health. Make sure to continue with the regular checks you were getting in your 20s and 30s including blood pressure, cholesterol and glucose levels, pap smears, dental checks and cleaning, skin cancer checks and weight assessments. But also consider the following important tests particular to this stage of your life:
Carried out by: GP
Frequency: Once between the ages of 45-49.
Why: Since 2006, the Australian Government has been offering this health check as a one-off service to patients aged 45 to 49 years who are at risk of developing a chronic disease such as type 2 diabetes or heart disease. The health check helps you to detect and take action to prevent chronic disease. In order to be eligible for this program, your doctor must be able to identify at least one risk factor such as lifestyle habits or a family history. The Australian Institute of Health and Welfare estimates that 94 percent of males and 89 percent of females between the ages of 45 to 54 years have at least one risk factor for cardiovascular disease
- Type 2 diabetes risk evaluation and lifestyle modification program
Carried out by: Arranged by your GP
Frequency: Once every three years between the ages of 40-49.
Why:The lifestyle modification program is a government initiative that helps people modify their risk factors for diabetes. It's presented as a series of group sessions supporting lifestyle changes and the adoption of healthy lifestyle choices to help delay or potentially even prevent getting type 2 diabetes. The program is available to adults between 40-49 years at high risk of type 2 diabetes your risk is first determined using the Australian type 2 diabetes risk assessment tool. More information can be found at www.health.gov.au/epc.
Carried out by: Ophthalmologist or optometrist
Frequency: Every two years for glaucoma from the age of 40, or from the age of 35 if you have a higher risk of the disease because of family history or other medical conditions.
Why: Glaucoma is the leading cause of blindness in Australia and while there is no cure once blindness occurs, early detection means that it can be controlled with little damage to the eye. Testing your eyes will not only detect abnormalities present such as glaucoma but can also identify changes due to diabetes, macular degeneration (another cause of vision loss) and plain refractive problems that can affect your driving, your risk of falls, workplace safety and overall quality of life.
- Breast exam and mammogram
Carried out by: Arranged by your GP and you can do regular self checks
Frequency: Regular self checks each month and a mammogram every two years - or more frequently if advised by your doctor.
Why: For early detection of breast cancer. The National Breast and Ovarian Cancer Centre says that while there is no right or wrong way to check your breasts, it's important to get to know your breasts so that you can notice changes more easily. Things to look for include changes in the size or shape of the breast or nipple, changes in the skin over the breast such as redness or dimpling, lumps or lumpiness. BreastScreen Australia offers free mammograms for women over the age of 40 every two years. Mammograms can be less effective for younger women because their breast tissue is generally more dense and can show up as white areas on the x-ray. Breast cancers also show up as white areas on x-rays. This makes breast cancer more difficult to detect in young women.
Carried out by: GP
Frequency: If you have symptoms
Why: If you notice any symptoms of prostate cancer, such as getting up to urinate more than twice a night or having difficulty with the strength of your urine stream or with starting to urinate, you should speak to your GP about your concerns. A prostate check usually involves a digital rectal examination and a test for elevated levels of a protein called prostate specific antigen (PSA). The PSA blood test can help with early prostate cancer detection, but an abnormal PSA test result can also be due to non-cancer causes. As many prostate tumours are slow-growing, and high PSA levels can be present for five to ten years before the onset of prostate cancer symptoms, The Cancer Council of Australia does not recommend routine regular screening for prostate cancer. But if you have a family history of prostate cancer or any other type of cancer, you should discuss the risks and benefits of a screening test with your doctor.
Health checks in your 50s and later
As you move into your 50s, regular preventative health checks with your GP become even more important. Make sure to continue with the regular checks you were getting in previous years including eye checks, breast exams, prostate checks, blood pressure, cholesterol and glucose levels, pap smears, dental checks and cleaning, skin cancer checks and weight assessments. Some additional health checks at this stage of life include:
Carried out by: Trained specialists at a radiology service
Frequency: Every five years, or on your GP's advice.
Why: The bone density scan is a painless x-ray scan that measures the strength of your bones to help identify osteoporosis, which is when your bones are at risk of breaking more easily. Women should have their first bone density scan at menopause, and then repeat the test every five years. However, your doctor may advise you to have a scan pre-menopause if you have an increased risk of developing osteoporosis due to factors such as family history, medication use and other medical conditions. Osteoporosis also affects one in three men in Australia over the age of 60. Men over the age of 50 should ask their doctor to assess their risk factors for osteoporosis and refer them for a bone density scan if required.
- Faecal occult blood test (FOBT)
Carried out by: You with some help from a pathology lab
Frequency: Every two years.
Why: The FOBT checks for the presence of blood in your stool, which is one of the symptoms of colon cancer or polyps, and is used for early detection of these conditions. The National Health and Medical Research Council recommends starting FOBT screening of people at average risk of developing colon cancer from the age of 50. If you turn 50, 55 or 60 before the end of 2010 you will receive an invitation in the mail before the end of the year to accept a free FOBT kit courtesy of the Australian Government's bowel cancer screening program. If you’re not eligible to participate in the program but you are interested in bowel cancer screening, you can speak to your doctor or pharmacist about other methods of accessing a FOBT kit. You can complete the test in the privacy of your own home and send it to the pathology lab for analysis. If the test comes back positive you may need to speak to your doctor about having a colonoscopy for a more thorough examination.
Carried out by: Audiologist, arranged by your GP
Frequency: If you have symptoms.
Why: Hearing problems can affect your quality of life. Fifty per cent of people in Australia have some level of hearing loss that makes communication difficult. Your doctor can treat minor conditions that cause temporary hearing loss, such as ear infections, but they can also refer you to a hearing service for more permanent hearing problems. Audiologists can carry out a range of hearing tests to determine your degree of hearing loss, and investigate possible causes of your hearing problems. Australian residents aged 21 years and over who hold a valid Pensioner Concession or DVA repatriation health care card may be eligible for government-funded hearing services.
Further information
Sources
Andrology Australia. PSA Test. [online] Clayton, VIC: Andrology Australia. c2005 [updated 2 Aug 2007, accessed 5 Aug 2010] Available from: http://www.andrologyaustralia.org/pageContent.asp?pageCode=FSPSA
Andrology Australia. Testicular Self-Examination. [online] Clayton, VIC: Andrology Australia. c2005 [updated 6 Mar 200, accessed 5 Aug 2010] Available from: http://www.andrologyaustralia.org/pageContent.asp?pageCode=FSTESTEXAM
The Australian Government Hearing Services Program. [online] Canberra, Act: Commonwealth of Australia. 2007 [updated 3 Aug 2010, accessed 5 Aug 2010] Available from: http://www.health.gov.au/hear
Australian Government Department of Health & Ageing. Health assessment for people aged 40 to 49 years with a high risk of developing type 2 diabetes. [Online] Canberra, ACT: Commonwealth of Australia. c2007. [updated 25 May 2007, accessed 2 Aug 2010] Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare_mbsitem_type2diabetes
Better Health Channel. Newborn screening. [Online] Melbourne, VIC: State Government of Victoria. c1999-2010 [updated Jan 2009, accessed 29 July 2010] Available from: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Newborn_screening
Better Health Channel. Immunisation - childhood. [Online] Melbourne, VIC: State Government of Victoria. c1999-2010 [updated Aug 2009, accessed 1 Aug 2010] Available from: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Childhood_immunisation
Braun K. Preconception Health. [online] Spring Hill, QLD: Women's Health Queensland Wide. May 2007. [updated 31 May 2007, accessed 31 July 2010] Available from: http://esvc000024.wic055u.server-web.com/factsheets/preconception.htm
BreastScreen Australia Program. [online] Canberra, ACT: Commonwealth of Australia. 2009 [updated 14 Sept 2009, accessed 5 Aug 2010] Available from: http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/breastscreen-about
Cancer Council Australia. Position Statement: Prostate cancer screening. [online] Surry Hills, NSW: Cancer Council Australia. Apr 2005 [updated Apr 2008, accessed 5 Aug 2010] Available from: http://www.cancer.org.au/File/PolicyPublications/Position_statements/PS-Prostate_cancer_screening_Apr08.pdf
Cancer Council NSW. Skin cancer detection, diagnosis and treatment. [online] Kings Cross, NSW: The Cancer Council NSW. c2008-2010 [accessed 5 Aug 2010] Available from: http://www.cancercouncil.com.au/editorial.asp?pageid=1315.
Children Youth and Women's Health Service. Health Checks. [Online] Adelaide, SA: Government of South Australia. [updated 8 Dec 2008, accessed 1 Aug 2010] Available from: http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=304&id=1480.
Immunise Australia. [online] Canberra, ACT: Commonwealth of Australia. c2002-2010 [updated 30 Jul 2010, accessed 5 Aug 2010] Available from: http://www.immunise.health.gov.au/.
Measure Up. [online] Canberra, ACT: Commonwealth of Australia. c2007 [updated 19 May 2010, accessed 5 Aug 2010] Available from: http://www.measureup.gov.au.
National Bowel Cancer Screening Program. [online] Canberra, ACT: Commonwealth of Australia. 2003 [updated 2 Nov 2009, accessed 5 Aug 2010] Available from: http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/bowel-about.
National Breast and Ovarian Cancer Centre (NBOCC). Breast Changes. [online] Surry Hills, NSW: NBOCC. 2009. [updated 25 Oct 2009, accessed 5 Aug 2010] Available from: http://www.nbocc.org.au/breast-cancer/awareness/breast-changes.
National Health and Medical Research Council. Clinical practice guidelines for the prevention, early detection and management of colorectal cancer. [online] Canberra, ACT: Commonwealth of Australia. 2005 [accessed 5 Aug 2010] Available from: http://www.nhmrc.gov.au/_files_nhmrc/file/publications/synopses/cp106/cp106.pdf.
National STI Prevention Program: Sexual Health Campaign. [online] Canberra, ACT: Commonwealth of Australia. c2009 [updated 29 May 2009, accessed 5 Aug 2010] Available from: http://www.sti.health.gov.au/internet/sti/publishing.nsf/Content/testing-faqs.
Royal Australian College of General Practitioners. 45 year old health check (MBS Item 717). [Online] South Melbourne, VIC: RACGP. 23 Oct 2006 [accessed 1 Aug 2010] Available from: http://www.racgp.org.au/clinicalresources/45.
Royal Australian College of General Practitioners (RACGP). Guidelines for preventive activities in general practice (The Red Book). 7th ed. [Online] South Melbourne, VIC: RACGP. 1 May 2009 [accessed 29 Jul 2010] Available from: http://www.racgp.org.au/redbook/.
Royal Hospital for Women. Preconception Health Information Checklist. [Online] Randwick, NSW: South Eastern Sydney and Illawarra Area Health Service. Sept 2008 [accessed 31 July 2010] Available from: http://www.sesiahs.health.nsw.gov.au/rhw/Documents/mothersafefactSheet.pdf.
Royal Women’s Hospital. Preparing for pregnancy – medical issues. [Online] Parkville, VIC:The Royal Women’s Hospital. Sept 2009 [accessed 31 July 2010] Available from: http://www.thewomens.org.au/PreparingforpregnancyMedicalissues.
Published: 8 August 2010
Last updated: 30 July 2011
