5 Lifesaving Tests
for Women
By Denise Mann

WebMD ranks the top five lifesaving health tests every woman needs.

From Rosie the Riveter to celebrated TV moms like Carol Brady and June Cleaver to CEOs of Fortune 500 companies, women certainly have a lot on their plates – and unfortunately their health often takes a back seat to their families and careers.

"The irony is that most women take better care of their cars than their body and that is in large part because an annual inspection is required to continue driving your car," says Donnica Moore, MD, a women's health expert based in Far Hills, N.J.

To encourage women to make the time for their own health, the U.S. Department of Health and Human Services (HHS) is launching their 4th annual National Women's Health Week -- starting off with National Women's Check-Up Day on Monday, May 15.

"Just like we have stickers on our cars to get your inspection renewed, use this week or your birthday (as I do), to get your checkups," Moore says. There is no reason not to. "We know that the earlier we identify any potential health problems, the better our outcome will be," she says. And "if you are totally well, it gives you great reassurance about a whole list of things don't need to worry about."

To make the task even easier, WebMD compiled a list of the top five lifesaving medical tests every woman needs and why.

No. 1 Heart Smarts

Heart disease claims about 500,000 women's lives a year. That's more than the next five causes of death combined, according to the American Heart Association. But it doesn't have to be this way, says Marianne J. Legato, MD, a professor of clinical medicine at Columbia University College of Physicians and Surgeons in New York City and the founder of the Foundation for Gender Specific Medicine. "Without a doubt, 80% of coronary disease can be prevented with proper lifestyle modifications including healthy diet and increased physical activity," says Legato, author of several books including Why Men Never Remember and Women Never Forget.

The best way to know where you stand is to get a yearly blood test for total cholesterol levels, high density lipoprotein (HDL) or "good" cholesterol, low density lipoprotein (LDL) or "bad" cholesterol, and blood fats known as triglycerides. "If you are older than 50, I also recommend getting your C-reactive protein (CRP), homocysteine, and lipoprotein (a) (LP(a)) checked," she says.

These blood factors are emerging risk factors for heart disease. CRP is an indicator of inflammation, while homocysteine is an amino acid that can build up in the bloodstream and increase your chances of having a heart attack. Lp(a) is a cholesterol-related risk factor that tends to increase blood clotting.

"If there is any question of extra heartbeats, chest pain, or shortness of breath, women should have a stress echocardiogram," she recommends. A stress echocardiogram is usually done to determine whether you have a significantly reduced flow of blood to your heart.

Also, your doctor should test your blood pressure, as high blood pressure is a major risk factor for heart disease, she says.

Diabetes is another risk factor for heart disease. If you have a family history of diabetes or are overweight, a blood sugar level or other tests for diabetes are something you should discuss with your doctor.

No. 2 The Power of the Pap Test

Starting three years after becoming sexually active or by age 21, whichever comes first, women need an annual pap test to detect any abnormal cell changes that could lead to cervical cancer. This recommendation comes from the American College of Obstetricians and Gynecologists (ACOG). During a Pap test, a small sample of cells from the surface of the cervix is taken and examined for abnormalities that may indicate cancer or changes that could lead to cancer.

According to ACOG, the Pap test should be done annually until age 30. After 30, if a healthy woman has had three completely normal and satisfactory Pap tests, she may be able to have a pap test every two to three years (but should still see a gynecologist every year for an exam). Cervical cancer was once the leading cause of death for women in the U.S., but the widespread use of the Pap test has significantly decreased deaths from this cancer.

But there's more. A human papillomavirus (HPV) test may be done as follow-up to an abnormal Pap test, says Phyllis Greenberger, MSW, president and CEO of the Society for Women's Health Research, based in Washington, D.C. HPV is a common sexually transmitted infection that can lead to cervical cancer. An HPV test can help determine whether one or more high-risk types of HPV caused the abnormal Pap test result.

"If you are younger than 30, it's recommended you have the HPV test if your Pap smear test detects abnormal cells or is unclear, and if you are 30 or older, experts recommend you have the HPV test at the same time as your Pap test," she says. This summer, new vaccines are expected to be licensed to provide protection against HPV.

No. 3 The Benefit of Mammograms

Women aged 40 and older should get a mammogram (breast X-ray) every one or two years, Greenberger says. "If there is a history of breast cancer in her family, a woman should get her first mammogram 10 years before her relative was diagnosed," she tells WebMD. Women older than 50 should have annual mammograms. Unfortunately, studies have suggested that women may not be getting their annual mammograms. "Some women just don't want to know, but with breast cancer being treatable in many cases and even curable, every woman should be getting this," she says.

Moore agrees: "If we catch a breast cancer in stage I, 97% of women who have it will be cured," she says. "As inconvenient as it is to schedule a mammogram, if it comes back clean, we know we are in the free and clear for a year, and that's reassuring."

In addition, most women should have an annual clinical breast exam by a doctor to feel for suspicious lumps and bumps. Although there are no definitive studies showing the benefit of self-breast exams, ACOG recommends this safe and easy test.

No. 4 The Katie Couric Test

Thanks to Katie Couric, more and more women are realizing that colon cancer is not just a man's disease. When Couric underwent a colonoscopy live on national television in March 2000, colonoscopies nationwide jumped more than 20% in the following days and months. She became a spokeswoman for this cause after the death of her husband, Jay Monahan, from colon cancer at age 42.

The American Cancer Society (ACS) estimates that about 106,680 new cases of colon cancer (49,220 men and 57,460 women) and 41,930 new cases of rectal cancer (23,580 men and 18,350 women) will be diagnosed in 2006.

A colonoscopy allows a doctor to see and closely inspect the inside of the entire colon for signs of cancer or polyps or small growths that can eventually become cancerous. The patient is first given a medication in a vein that causes sleepiness and relaxation. A colonoscope is gently eased inside the colon; it has a tiny video camera, which sends pictures to a TV monitor. Small puffs of air are introduced into the colon to keep it open and allow the doctor to see clearly.

Preparation-wise, you follow a special diet the day before the exam and take a very strong laxative in the hours before the procedure. You may also need an enema to cleanse the colon. Excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in men and in women in the U.S.

"Colon cancer is totally preventable and treatable if they find it early," Greenberg says. "Every man and woman should have it despite the fact that it is an unpleasant experience."

Beginning at age 50, men and women who are at average risk for developing colorectal cancer should have a colonoscopy every 10 years, according to the ACS.

No. 5 Skin Sense and Sensibility

"Every woman at the age of 18 should start having an annual skin exam by their dermatologist," recommends Ellen S. Marmur, MD, chief of the division of dermatology and cosmetic surgery at the Mount Sinai Medical Center in New York City. "This entails a head-to-toe skin exam looking for unusual brown or red spots " she says.

But "every month you should do a skin self-exam using a hand mirror or hair blower to part your hair and look at your scalp. Don't forget to check for unusual or new moles on your fingernails, the bottom of your feet and toes, and your underarms. The earlier you start doing this, the better you will know your skin, and if you find something suspicious, your brain will start off an alarm and that will bring you in to see your doctor earlier."

Melanoma accounts for about 4% of skin cancer cases, but it causes most skin cancer deaths. The number of new cases of melanoma in the U.S. is on the rise. In fact, the ACS estimates that in 2006 there will be 62,190 new cases of melanoma in this country. About 7,910 people will die of this disease.

Published May 12, 2006. Courtesy of Anthem Blue Cross and Blue Shield.

Reviewed By Ann Edmundson

SOURCES: Donnica Moore, MD, women's health expert, Far Hills, N.J. Marianne J. Legato, MD, professor of clinical medicine, Columbia University; founder, Foundation for Gender Specific Medicine; author, Why Men Never Remember and Women Never Forget. Ellen S. Marmur, MD chief, division of dermatology and cosmetic surgery, Mount Sinai Medical Center, New York. Phyllis Greenberger, MSW, president and CEO, Society for Women's and Health Research. American College of Obstetrics and Gynecology Guidelines. The American Cancer Society. American Heart Association.

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