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Karen Josephson, MD
Ask the Expert Doctor

February 2nd, 2008
How do I know what type of preventive tests seniors should have done?

The recommendations vary by medical organizations (oncologists, cardiologists…)
The preventive tests should be done if the result will change your treatment. For example, continue to perform mammograms if you would seek treatment should you have cancer. The following screening tests I generally advise: diabetes (fasting blood sugar and possibly a 2 hour post prandial sugar), heart disease (baseline EKG, and if never done a stress test), hypertension, fasting lipid profile (if under 70 yrs or a history of heart disease), memory (if above 70 yrs or problems with memory), thyroid, Vitamin B 12 level, Vitamin D level ( get the 25 hydroxy Vitamin D), PSA (younger than 70), evaluation of fall risk, colonoscopy after age 50, complete metabolic panel and blood count. There is also a push for carotid Doppler and screening for abdominal aortic aneurysms. Certainly, any specific findings during an exam may prompt other testing, such as an X-ray. I do not believe in fishing expeditions (whole body CT scans) as they expose you to a lot of radiation and may prompt unnecessary surgeries. The key is always a thorough physical exam.

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