Health checks you should have: a checklist

Health screening is an important part of disease prevention. There are many screening tests and examinations that healthy people can undertake to help with detection of diseases such as cancer. Your General Practitioner is well placed to carry out some of these tests, refer you to have other tests, or to advise you on some of the self-checks you can be doing to monitor your health. One of the key roles of your GP is to prevent disease, so they will be only too happy to help you.

The recommendations below often refer to screening for the general population — for people with specific risk factors for a particular disease the recommendations may be different. Your GP will be able to advise you if you are in any doubt.

MEN

Health checks men should have
Disease or condition Who should be tested or examined? Test or examination Frequency Guideline
Bowel cancer (colorectal cancer) People over the age of 50 Faecal Occult Blood Test (FOBT) At least every 2 years Australian Cancer Network, NHMRC, Department of Health and Ageing, RACGP and Cancer Council Australia, 2008
People at increased risk of colorectal cancer, for example because of family history Colonoscopy Usually every 5 years. The age to start depends upon the family history Australian Cancer Network, NHMRC, Department of Health and Ageing, RACGP and Cancer Council Australia, 2008
Cardiovascular disease (CVD), such as heart attack and stroke People aged 18 to 50 Blood pressure measurement Every 2 years if normal RACGP, 2009
People aged 45 and above and Aboriginal and Torres Strait Islander peoples aged 35 and over at low risk of CVD Cholesterol and triglyceride blood tests and blood pressure, waist circumference and BMI measurements Every 2 years National Vascular Disease Prevention Alliance, 2009
People at moderate risk of CVD Cholesterol and triglyceride blood tests and blood pressure, waist circumference and BMI measurements Every 6 to 12 months National Vascular Disease Prevention Alliance, 2009
People at high risk of CVD Cholesterol and triglyceride blood tests and blood pressure, waist circumference and BMI measurements You should be reviewed regularly. Your doctor will advise you how often you need to be monitored National Vascular Disease Prevention Alliance, 2009
Dental health  Dental check up Your dentist should be able to advise you on the timing of dental examinations 
Diabetes: type 2 People aged 40 and over and Aboriginal and Torres Strait Islander peoples aged 18 and over Australian Type 2 Diabetes Risk Assessment Tool (questionnaire) Every 3 years Diabetes Australia, NHMRC and RACGP, 2009
People at high risk of type 2 diabetes:
  • People with impaired glucose tolerance or impaired fasting glucose
Fasting blood sugar level Every 12 months Diabetes Australia, NHMRC and RACGP, 2009
People at high risk of type 2 diabetes:
  • Aboriginal and Torres Strait Islander peoples 35 years and over
  • Pacific Islander people, people from the Indian Subcontinent or of Chinese origin
  • People aged 45 and over who have either or both of: (a) obesity (BMI 30 or more); (b) high blood pressure
  • People who have had myocardial infarction (heart attack), angina, stroke or peripheral vascular disease
  • People taking antipsychotic medicines
Fasting blood sugar level Every 3 years Diabetes Australia, NHMRC and RACGP, 2009
Glaucoma Everybody should have their first eye check at 40, unless they have risk factors for glaucoma, in which case they should have their first eye check at 35.
Risk factors include:
  • family history of glaucoma
  • diabetes
  • migraine
  • short sightedness (myopia)
  • eye injuries
  • high blood pressure
  • past or present use of steroids (cortisone drugs)
Eye examination Both groups should have regular eye checks after the first examination Glaucoma Australia, 2006
Obesity Adults aged 18 and over BMI and waist circumference measurement Every 2 years or in groups at increased risk of obesity every 12 months and in those identified as being overweight or obese every 6 months RACGP, 2009
Skin cancer - melanoma Everybody Self skin examination Every 3 months RACGP, 2009
People at high risk of melanoma, e.g.:
  • People with multiple atypical or dysplastic naevi (moles with unusual appearance); or
  • people who have a history of melanoma themselves or in a first degree relative
Self skin examination and skin examination by a doctor, including photography if required Your doctor or dermatologist will be able to advise how often; full body examination is recommended every 6 months Cancer Council Australia, Australian Cancer Network, New Zealand Ministry of Health and NHMRC, 2008
Testicular cancer Men from puberty onwards. The Cancer Council Australia says that it is sensible for men to become familiar with the usual level of lumpiness of their testicles and to see their doctor if they notice a change. Men with a family history of testicular cancer (father or brother) or a personal history of absent or undescended testicles in particular should regularly check for lumps or swellings on the surface of the testicles Testicle self-examination  Cancer Council Australia Position Statement 2004 (reviewed 2008) and RACGP, 2009
Visual and hearing impairment People 65 years and over Eye test and hearing test Every 12 months RACGP, 2009
Tests which are controversial or not recommended in the general well population
Prostate cancer Cancer Council Australia does NOT support population-based screening of men with no symptoms for prostate cancer
  • Prostate specific antigen (PSA) blood test
  • Digital rectal examination (DRE)
  Cancer Council Australia Position Statement 2005 (updated 2008)
BMI = Body Mass Index
NHMRC = National Health & Medical Research Council, Australia
RACGP = Royal Australian College of General Practitioners

WOMEN

Health checks women should have
Disease or condition Who should be tested or examined? Test or examination Frequency Guideline
Bowel cancer (colorectal cancer) People over the age of 50 Faecal Occult Blood Test (FOBT) At least every 2 years Australian Cancer Network, NHMRC, Department of Health and Ageing, RACGP and Cancer Council Australia, 2008
People at increased risk of colorectal cancer, for example because of family history Colonoscopy Usually every 5 years. The age to start depends upon the family history Australian Cancer Network, NHMRC, Department of Health and Ageing, RACGP and Cancer Council Australia, 2008
Breast cancer For women with no symptoms who are at average risk of breast cancer, the Cancer Council Australia says: Be 'Breast Aware' by familiarising yourself with the normal look and feel of your breasts. See a doctor immediately if you notice any unusual breast changes. The Cancer Council has adopted this less formal 'Breast Awareness' approach in the absence of proof that routine systematic breast self-examination reduces deaths from breast cancer across the population 'Breast Awareness'  Cancer Council Australia Position Statement, 2004 (updated 2009)
Women aged 50 to 69 years of age through BreastScreen Australia Mammogram Every 2 years Cancer Council Australia Position Statement, 2004 (updated 2009)
All women aged over 40 have free access to BreastScreen should they choose to have a mammogram. Women over 70 years may continue to have free mammograms, but should discuss with their doctor Mammogram  Cancer Council Australia Position Statement, 2004 (updated 2009)
Women at high risk of breast cancer (e.g. those who have had breast cancer in the past or who have a strong family history of breast cancer) should discuss their screening options with their doctor Options include: annual mammograms, breast ultrasound, breast magnetic resonance imaging scans and regular clinical breast examination by a doctor Discuss with your doctor Cancer Council Australia Position Statement, 2004 (updated 2009)
Cervical cancer All women between the ages of 18 (or two years after the first time of having sex, whichever is later) and 70. If you are over 70 you should discuss the need for testing with your doctor Pap smear Every 2 years. Women at increased risk of cervical cancer may need more frequent screening Cancer Council Australia Position Statement, 2006, and National Cervical Screening Program, 2009
Cardiovascular disease (CVD), such as heart attack and stroke People aged 18 to 50 Blood pressure measurement Every 2 years if normal RACGP, 2009
People aged 45 and above and Aboriginal and Torres Strait Islander peoples aged 35 and over at low risk of CVD Cholesterol and triglyceride blood tests and blood pressure, waist circumference and BMI measurements Every 2 years National Vascular Disease Prevention Alliance, 2009
People at moderate risk of CVD Cholesterol and triglyceride blood tests and blood pressure, waist circumference and BMI measurements Every 6 to 12 months National Vascular Disease Prevention Alliance, 2009
People at high risk of CVD Cholesterol and triglyceride blood tests and blood pressure, waist circumference and BMI measurements You should be reviewed regularly. Your doctor will advise you how often you need to be monitored National Vascular Disease Prevention Alliance, 2009
Dental health  Dental check up Your dentist should be able to advise you on the timing of dental examinations 
Diabetes: type 2 People aged 40 and over and Aboriginal and Torres Strait Islander peoples aged 18 and over Australian Type 2 Diabetes Risk Assessment Tool (questionnaire) Every 3 years Diabetes Australia, NHMRC and RACGP, 2009
People at high risk of type 2 diabetes:
  • People with impaired glucose tolerance or impaired fasting glucose
Fasting blood sugar level Every 12 months Diabetes Australia, NHMRC and RACGP, 2009
People at high risk of type 2 diabetes:
  • Aboriginal and Torres Strait Islander peoples 35 years and over
  • Pacific Islander people, people from the Indian Subcontinent or of Chinese origin
  • People aged 45 and over who have either or both of: (a)obesity (BMI 30 or more; (b) high blood pressure
  • People who have had myocardial infarction (heart attack), angina, stroke or peripheral vascular disease
  • People taking antipsychotic medicines
  • Women with polycystic ovary syndrome
  • Women who have had gestational diabetes
Fasting blood sugar level Every 3 years Diabetes Australia, NHMRC and RACGP, 2009
Glaucoma Everybody should have their first eye check at 40, unless they have risk factors for glaucoma, in which case they should have their first eye check at 35.
Risk factors include:
  • family history of glaucoma
  • diabetes
  • migraine
  • short sightedness (myopia)
  • eye injuries
  • high blood pressure
  • past or present use of steroids (cortisone drugs)
Eye examination Both groups should have regular eye checks after the first examination Glaucoma Australia, 2006
Obesity Adults aged 18 and over BMI and waist circumference measurement Every 2 years or in groups at increased risk of obesity every 12 months and in those identified as overweight or obese every 6 months RACGP, 2009
Skin cancer - melanoma Everybody Self skin examination Every 3 months RACGP, 2009
People at high risk of melanoma, e.g.:
  • People with multiple atypical or dysplastic naevi (moles with unusual appearance); or
  • people who have a history of melanoma themselves or in a first degree relative
Self skin examination and skin examination by a doctor, including photography if required Your doctor or dermatologist will be able to advise how often; full body examination is recommended every 6 months Cancer Council Australia, Australian Cancer Network, New Zealand Ministry of Health and NHMRC, 2008
Visual and hearing impairment People 65 years and over Eye test and hearing test Every 12 months RACGP, 2009
BMI = Body Mass Index
NHMRC = National Health & Medical Research Council, Australia
RACGP = Royal Australian College of General Practitioners
Last Reviewed: 18 November 2009
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References

1. Clinical practice guidelines for the prevention, early detection and management of colorectal cancer: a guide for general practitioners. Edition 3. Australian Cancer Network, in conjunction with the NHMRC, the Department of Health and Ageing, RACGP, and Cancer Council Australia. Available from: http://www.cancer.org.au/File/HealthProfessionals/ClinicalpracticeguidelinesJuly2008.pdf (accessed Dec 09).
2. RACGP. Guidelines for preventive activities in general practice. 7th ed. RACGP; 2009. Available from:
http://www.racgp.org.au/Content/NavigationMenu/ClinicalResources/RACGPGuidelines/TheRedBook/redbook_7th_edition_May_2009.pdf (accessed Dec 09).
3. National Vascular Disease Prevention Alliance. Guidelines for the assessment of absolute cardiovascular disease risk. 2009. Available from: http://www.heartfoundation.org.au/SiteCollectionDocuments/A_AR_Guidelines_FINAL%20FOR%20WEB.pdf (accessed Dec 2009).
4. Colagiuri S, Davies D, Girgis S, Colagiuri R. National Evidence Based Guideline for Case Detection and Diagnosis of Type 2 Diabetes. Diabetes Australia and the NHMRC, Canberra 2009.
Available from: http://www.diabetesaustralia.com.au/For-Health-Professionals/Diabetes-National-Guidelines/ (accessed Dec 2009).
5. Diabetes management in general practice: guidelines for type 2 diabetes 2009/10. Diabetes Australia and RACGP Available from: http://www.diabetesaustralia.com.au/For-Health-Professionals/Diabetes-National-Guidelines/ (accessed Dec 2009).
6. Glaucoma Australia. What is glaucoma [Website]. Updated February 2006. Available from: http://www.glaucoma.org.au/whatis.htm (accessed Dec 2009).
7. Australian Cancer Network Melanoma Guidelines Revision Working Party. Clinical Practice Guidelines for the Management of Melanoma in Australia and New Zealand. Cancer Council Australia and Australian Cancer Network, Sydney and New Zealand Guidelines Group, Wellington (2008). Available from: http://www.cancer.org.au/File/HealthProfessionals/ClinicalPracticeGuidelines-ManagementofMelanoma.pdf (accessed Dec 2009).
8. Position statement. Testicular cancer. Cancer Council Australia; 2004 (reviewed April 2008). Available from: http://www.cancer.org.au//File/PolicyPublications/PStesticularcancerupdatedApr08.pdf (accessed Dec 2009).
9. Position statement. Prostate cancer screening. Cancer Council Australia
Reviewed; 2008 (reviewed June 2009). Available from: http://www.cancer.org.au/File/PolicyPublications/Position_statements/PS-Prostate_cancer_screening_Apr08.pdf (accessed Dec 2009).
10. Position statement. Breast cancer. Cancer Council Australia; 2004 (updated June 2009). Avialable from: http://www.cancer.org.au/File/PolicyPublications/Position_statements/PS-Early_detection_of_breast_cancer_reviewed_May04_updated_Jun09.pdf (accessed Dec 2009).
11. Position statement. Cervical cancer screening. Cancer Council Australia; 2006. Available from: http://www.cancer.org.au//File/PolicyPublications/PScervicalcancerscreeningMARCH06.pdf (accessed Dec 2009).
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