Health tests - the ones you need and why

These days, a huge part of my time is taken up with preventive medicine. But the array of possible tests is dizzying. How do you work out what test you should be doing when - or why?

When I was a girl, we had preventive medicine - it was called 'an apple a day keeps the doctor away'. Back then, you only went to the doctor if you were ill. These days, a huge part of my time is taken up with preventive medicine - stopping healthy people getting ill or, if they have a medical condition, treating it early to prevent complications. But the array of possible tests is dizzying. How do you work out what test you should be doing when - or why?

Cholesterol and blood pressure

Heart attack and stroke are the biggest killers in the UK, and raised cholesterol and blood pressure increase your risk dramatically. But you won't know they're raised unless you get them checked. A simple blood pressure measurement and blood test will let your doctor assess your overall risk of heart attack or stroke. You can then decide together if you need regularly monitoring or medication. Whatever your risk, a healthy diet and stopping smoking will always cut your risk!

Cervical smears

A smear test takes a sample of cells from the surface of the neck of the womb, or cervix. The whole point of smears is to pick up changes and treat them before they become cancerous. Cells in the cervix often get slightly inflamed - often these settle down on their own, but sometimes they change (often over years rather than months) to cancer cells. That's why sometimes after a smear you'll be invited back for another test sooner, to check the inflammation has settled. If more severe inflammation is found, you'll be invited for a colposcopy - a sort of 'super smear' done as an outpatient - to take a more detailed look at your cervix and remove abnormal cells. In England you're invited regularly from 25-64; in Scotland from 20-60 and in Wales and Northern Ireland from 20-64.

Bowel screening

Screening for bowel cancer aims to pick up cancer at an earlier stage, before you get symptoms, because treatment is more likely to be successful at this stage. We all know blood in your stool needs checking out - this test looks for traces of blood you can't see. It's estimated that screening could cut death rates from bowel cancer by 16% - yet sadly, fewer than half of people invited return their test. Don't be a statistic! If you're 60-74 in England or Wales, 50-74 in Scotland or 60-71 in Northern Ireland you should be invited every two years.

Breast screening

If you're 50-70, you should be invited for a mammogram - a special xray of your breasts - every three years. Over the next couple of years, the age across the UK is being rolled out to include women from 47-73, and even if you're not invited when you're over 70, you can still request a mammogram every three years by phoning your local breast screening service. Breast cancer affects about one in nine women over a lifetime, and picking it up earlier using this test cuts the risk of dying from breast cancer by about 20%. There is a downside - research in 2012 showed that about 4,000 women were treated unnecessarily as a result. If you're in doubt about having this test, speak to your GP rather than just ignoring the invitation.

Tests for tiredness

In our busy world, who hasn't felt exhausted now and again? But if you have severe or long-lasting tiredness, do speak to your GP. It could be down to anaemiaunderactive thyroid, type 2 diabetes or occasionally kidney or liver problems. A simple blood test could clear up the mystery.

One for the chaps!

Prostate cancer is the most common cancer in men in the UK. Unfortunately, the screening test we have - a blood test called PSA - isn't ideal. About two thirds of men who have a raised result don't have prostate cancer, but will need further tests which can cause complications. But if prostate cancer runs in your family, if you're of Afro-Caribbean origin (men of Afro-Caribbean origin are at higher risk of prostate cancer) or you have any waterworks symptoms - getting up often at night, needing to rush to get to the loo but not being able to go straight away when you get there, a poor flow of urine - speak to your GP. It may turn out to be the very common condition benign prostatic enlargement but your doctor can give you advice and help with this, too

With thanks to 'My Weekly' magazine where this article was originally published.

Dr Sarah is unable to provide medical advice or respond directly to questions concerning your health. If you have health concerns we recommend contacting your GP.