I’m a doctor and these are the five health tests to have by December to reduce your risk of early death – and the terrifying stats you need to know

Pathology experts have urged Australians to keep up to date with health testing this year to pick up potential life-threatening diseases while they’re still treatable.

There are five that everyone should be aware of: the cholesterol test, STI tests, cancer screenings (bowel, cervical and breast), kidney checks and the Liver Function Test (LFT). 

Pathology testing is crucial for Australians to remain healthy, with their first test happening just minutes after they are born.

And while many Aussies delay or avoid these tests until they have symptoms to report, booking in at the suggested age or within the advised timeframe is often the difference between life and death.

Pathology experts have urged Australians to keep up to date with health testing this year to pick up life-threatening diseases while they’re still treatable

1. Cholesterol test 

Most people will likely have heard of ‘high cholesterol’ and the importance of taking action to bring it down if it is too high. 

Too much cholesterol can lead to health problems as the extra LDL cholesterol builds up in the walls of the arteries, forming plaques and causing a medical problem called atherosclerosis. These can first narrow then block your arteries, making it harder for blood to flow through. 

More than two in five (41.9%) Australian adults are living with high cholesterol. Prevalence is highest amongst those aged 55 to 64 years of age.

There are a number of factors that put people at risk and for those aged 45 and over, risk will be increased if high cholesterol and heart disease runs in the family. 

For those under 45, other risk factors include smoking, excess weight, diabetes, and high blood pressure. 

‘Heart disease is still the number one cause of death for Australians. To reduce this risk, the factors which contribute to damaging the arteries of the heart need to be measured and then treated (if needed),’ Professor Graham Jones, a chemical pathologist, said.

Testing cholesterol in its different forms is a vital part of this process and Australian pathology laboratories provide a world-class service for this testing. A cholesterol test is a simple blood test that looks for several fatty compounds called lipids, including low density lipoprotein, known as LDL-C. 

2. STI (Sexually Transmitted Infection) tests 

For those that are sexually active, you should be getting STI testing once a year. This includes testing for chlamydia, syphilis, and gonorrhoea, as well as the two H’s: HIV and hepatitis. 

In 2020, there were about 57,500 new cases of notifiable STI among females and 67,400 among males in Australia.

Between 2015 and 2019, STI notification rates increased by 17 per cent for chlamydia, nearly 79 per cent for gonorrhoea and 95 per cent for infectious syphilis.

‘Chlamydia and gonorrhoea are the STIs that people are most aware of and get tested for regularly. Though testing for syphilis, HIV and hepatitis B, which people don’t think about as much are as important to test for, particularly with the recent rise in community syphilis infections,’ A/Prof Caitlin Keighley, a microbiologist, said.

Reasons to test more regularly include if you have symptoms such as pain, discharge, bleeding, or lumps (though not all STIs show symptoms). 

You should also get tested if you have engaged in unprotected sex, are aware that a sexual partner has tested positive for an STI, or you have multiple sexual partners or a new sexual partner. 

There is no single pathology test that covers all STIs. Examples include urine tests that can identify STIs such as chlamydia or gonorrhoea, along with blood tests that can detect antibodies produced in response to infections such as hepatitis B, HIV, syphilis. 

If STIs are not detected and treated, the health effects can be significant. 

'Chlamydia and gonorrhoea are the STIs that people are most aware of and get tested for regularly,' A/Prof Caitlin Keighley, a microbiologist, said

‘Chlamydia and gonorrhoea are the STIs that people are most aware of and get tested for regularly,’ A/Prof Caitlin Keighley, a microbiologist, said

3. Cancer screening tests 

In Australia, three crucial cancer screening programs are available:

Cervical Cancer Screening: 

This test tests for the Human Papillomavirus (HPV) which is a virus known to cause most types of cervical cancer. It is a simple procedure to check the health of the cervix and any cell changes.

These slow changes, if picked up, could develop into cancer if they are left untreated.  Anyone with a cervix ages 25-74 should be getting this screens every five years. 

And for those unsure about seeing a doctor, on July 1 2022, self-collection of samples became available to anyone in in this category around the country. This means patients no longer need their GP or nurse to insert a speculum to collect the cervical sample.

‘In Australia we are lucky to have one of the best cervical screening programs in the world. It is important that people know that they can access this program easily through their GP,’ Adj Prof Annabelle Farnsworth, an anatomical pathologist, said.

‘Importantly, GPs will then be able to guide patients through any subsequent follow-up if the test returns positive for human papillomavirus.’

In Australia, a female has a one in 180 risk of being diagnosed with cervical cancer by the age of 85.

'In Australia we are lucky to have one of the best cervical screening programs in the world. It is important that people know that they can access this program easily through their GP,' Adj Prof Annabelle Farnsworth, an anatomical pathologist, said

‘In Australia we are lucky to have one of the best cervical screening programs in the world. It is important that people know that they can access this program easily through their GP,’ Adj Prof Annabelle Farnsworth, an anatomical pathologist, said

Bowel Cancer Screening: 

Australians aged 50 to 74 are eligible for bowel cancer screening. This pathology test involves testing a small stool sample every two years and collection of the sample can be done at home. Early detection of bowel cancer through screening can increase the chances of successful treatment and be potentially lifesaving. 

Over 90 per cent of bowel cancer cases are successfully treated if caught early, and as a result, Aussies are encouraged to keep up to date with this quick and easy test.

According to a 2017 study by Cancer Council Australia, screening for bowel cancer can reduce deaths from the disease by between 15 and 25 per cent. 

Bowel cancer (also known as colorectal cancer) is the third most common type of newly diagnosed cancer in Australia.

15,610 Australians are told they have bowel cancer each year (300 a week), including 1,680 people under the age of 50. It claims the lives of 5,354 people every year (103 a week), including 290 people under the age of 50.

Breast Screening: 

Women aged 50 to 74 are encouraged to undergo breast screening for breast cancer through mammograms every two years. If an abnormality is detected, a breast biopsy may be recommended. This involves the collection of tissue samples from the breast area for pathology analysis. This procedure helps determine whether the abnormality is benign (non-cancerous) or malignant (cancerous).

A woman has a one in 15 risk of being diagnosed with breast cancer by the age of 85 (1 in 668 or 0.15 per cent for males and 1 in 8 or 13 per cent for females). 

4. Kidney checks 

Currently over two million Australians are unaware they are living with early signs of kidney disease and one in three are at risk.

Kidney testing is particularly important for individuals with risk factors such as diabetes, high blood pressure, or a family history of kidney disease. 

Blood and urine pathology tests can assess kidney function and detect signs of disease. 

These tests evaluate factors such as the presence of protein or blood in the urine. They should be done annually for those at high risk, or as recommended by your healthcare provider. 

‘The early stages of kidney disease are clinically silent meaning there are no symptoms and nothing your doctor can find when they examine you,’ Professor Jones said.

‘Laboratory tests on blood and urine are the only way to find this disease in its early stages. If it found early, then treatments can be given to improve the management of this common condition, with laboratory tests also vital to monitor progress.’

‘Heart disease is still the number one cause of death for Australians. To reduce this risk, the factors which contribute to damaging the arteries of the heart need to be measured and then treated (if needed),’ Professor Graham Jones, a chemical pathologist, said

5. Liver Function Test (LFT) 

The Liver Function Test is made up of blood tests that give insight into how well a person’s liver is working. 

This is made up of multiple blood tests that detect substances in the blood, including proteins and enzymes, that are produced by liver cells when they’re damaged. 

Which one to order is best decided while looking at your family and health history with your GP. There are seven in total. 

Behaviours such as increased alcohol consumption and reduced exercise can have a negative impact on liver health. The tests are also recommended for those who have a family history of liver disease or are infected with hepatitis. 

Your doctor might also suggest a liver function test if you are experiencing itching, dark urine, weakness or tiredness, nausea or vomiting or a lass of appetite. 

More than six million Australians suffer from chronic liver disease and one in three has a fatty liver.

In 2020, liver cancer was the seventh most common cause of cancer death in Australia. 

Pathology Awareness Australia runs the Know Pathology Know Healthcare initiative to educate Australians on the role of pathology in healthcare.

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