1. Mammogram (Screening for Breast Cancer)

Mammogram plays a crucial role in the early detection of breast cancer among women. This screening test utilises x-rays to create detailed images of the breast tissue. By capturing these images, mammograms are effective in identifying small lumps that may not be detectable through physical examination alone. It serves as a valuable tool in screening for breast cancer and promoting early intervention.

Determining who should undergo mammography

For women in the general population between the ages of 50 and 74, regular mammography screening can be done every two years.

For women who are at a high risk of developing breast cancer and have not been identified with any genetic variants, they should undergo mammography screening starting from 30-39 years old and annually from 40-59 years old.

For women over 60 years old, mammography can be performed every two years.

Mammogram procedure

• You would have to remove your clothes and wear an open-front hospital gown or drape. Remove jewellery and avoid using products that may interfere with the imaging process.
• Position yourself near the X-ray machine. The radiographer positions one breast at a time between the machine's two flat plates.
• The plates press your breast firmly between them for a few moments. You will feel some pressure, and it may be unpleasant.
• Typically, two X-rays are taken of each breast: one from the top and one from the side.
• Inform your mammographer if you feel anxious or embarrassed or if the mammogram is too painful. At any time, they can stop and try to make you feel more comfortable.

2. Pap Smear / Pap Test (Screening for Cervical Cancer)

Pap smear (or Pap test) is considered a primary screening tool for cervical cancer. This screening test is performed to detect abnormal cell changes in the cervix (the opening between the vagina and the uterus).

Determining who should go for pap smear / pap test

Screening for cervical cancer is an essential component of women's health care. You should begin screening at age 21, regardless of when you had your first sexual encounter.

How often and which tests you should undergo for cervical cancer screening depends on your age and medical history.

Women aged 21 to 29 should undergo Pap smear testing every three years.

There are three testing options for women aged 30 to 65:

• Pap test and HPV test (co-testing) every five years.
• Pap test every three years.
• HPV test alone once every five years.

Pap smear procedure

• The doctor will insert an instrument called the speculum into the vagina to widen it to view the cervix and upper portion of the vagina.
• The doctor will gently swab the lower part of the cervix to collect cell samples using a spatula (Ayre's spatula), whereas a brush (cytobrush) is used to obtain cells from the inner part of the cervix.
• The sample collected is placed in a liquid preservative and sent to the laboratory for examination.

Some people may experience discomfort, and others may find the test to be painful during the procedure. If you are experiencing discomfort or pain, inform your doctor so they can discuss some options to alleviate pain.

Pap smear result

• Normal or negative results indicate no cell changes in your cervix. No further testing is required until your next scheduled test.
• Abnormal results indicate cell changes were detected in your cervix, although this does not necessarily mean that you have cervical cancer. Abnormal changes are most likely caused by HPV. The changes may be mild (low-grade) or severe (high-grade). Mild changes may return to normal on their own. The more severe changes are often called "precancers" as they are not cancerous yet but have the potential to develop into cancer over time. In uncommon circumstances, an abnormal Pap smear may indicate the presence of malignancy (cancer). There will be a need for additional examinations to confirm the diagnosis. The earlier cervical cancer is detected, the more treatable it is.
• For unclear results, which rarely happen, your doctor would advise you to repeat the test in 12 weeks.

3. Blood Tests

A blood test typically involves taking a blood sample from a vein in your arm. This is done by inserting a small needle into a vein, typically located in the inner elbow area. Once the blood sample is obtained, a cotton ball or gauze pad will be applied to the puncture site to stop any bleeding. Generally, the entire procedure lasts only a few minutes.

Commonly performed blood tests include:

1. Complete blood count (CBC)
   • Also known as full blood count.
   • Measures haemoglobin levels, white and red blood cell count, and platelet count.
   • CBC can help detect infections, anaemia, and other conditions.
2. Blood glucose test
   • Measures the amount of glucose (sugar) in your blood. Glucose is an essential source of energy for your body, but high levels of glucose in your blood can be a sign of diabetes or other health problems.
   • Fasting Blood Glucose Test measures your blood glucose level after you have fasted for 8-12 hours. It can help diagnose diabetes or prediabetes.
   • Random Blood Glucose Test measures your blood glucose level at any time of the day, regardless of when you last ate. It can help diagnose diabetes or monitor glucose levels in people with diabetes.
   • HbA1c Test is a three-month average blood glucose indicator which helps diagnose and monitor diabetes.
3. Lipid profile (Cholesterol test)
   • Measures the levels of high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol, triglycerides, and very-low-density lipoprotein (VLDL), which are important markers for your cardiovascular health.
4. Liver function test
   • Measures the levels of liver enzymes and proteins in the blood.
   • Common tests include Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Alkaline Phosphatase (ALP), Total Bilirubin, Albumin, and Prothrombin Time (PT).
   • Helps diagnose liver diseases, such as hepatitis or cirrhosis, and monitor liver function in people with these conditions.
5. Renal function test
   • Helps diagnose kidney diseases and monitor kidney function in people with known kidney conditions.
   • Common tests include creatinine, sodium, calcium, chloride, potassium, Glomerular Filtration Rate (GFR), and Blood Urea Nitrogen (BUN).

4. Urinalysis (Urine analysis)

Urinalysis or urine analysis is commonly used to screen for various medical conditions, including urinary tract infections, kidney disease, diabetes, and liver problems.

Below are parameters that are typically evaluated in a urine analysis test:

• Colour and clarity
• pH level
• Specific gravity
• Protein levels
• Glucose levels
• Ketone levels
• Nitrite levels
• Leukocyte levels
• Bilirubin levels
• Urobilinogen levels
• Red and white blood cell counts
• Bacteria or other microorganisms

5. Blood Pressure Test

A blood pressure test determines whether your blood pressure is normal, high, or low. Blood pressure is typically tested using a blood pressure cuff and a device called a sphygmomanometer.

• During the test, you will usually be seated with your arm resting on a surface at about heart level.
• Your upper arm would then be wrapped with the blood pressure cuff and inflated, temporarily stopping the blood flow in your arm. This may be uncomfortable, but it only lasts a few seconds. It is crucial to relax during this time and not talk.
• Your doctor would then slowly release the pressure in the cuff while listening to your pulse with a stethoscope and watching the gauge on the sphygmomanometer.

The test results are typically expressed as two numbers, with the systolic pressure listed first and the diastolic pressure listed second. Normal blood pressure is generally considered to be less than 120/80 mmHg. High blood pressure is defined as a reading of 130/80 mmHg or higher.

6. Bone Density Test (Screening for Osteoporosis)

The most commonly used method to measure bone density is a dual-energy X-ray absorptiometry (DEXA) scan, also known as a bone density scan. It uses low-intensity X-ray beams to measure calcium and other minerals in one's bones.

Individuals over 65 years old are advised to undergo this test once every two years. For females over 65 years old with no risk of accelerated bone loss, it can be performed every 3 to 5 years.

Bone density test procedure

• A bone density scan is a simple and painless procedure where you will be required to lie on your back on an X-ray table for an area of your body to be scanned.
• Depending on the area being scanned, you may be permitted to keep your clothes on. However, you will need to remove anything with a metal clasp, snap, or button. A gown may be required depending on the circumstance.
• The scan involves a large scanning arm passed over your body to evaluate bone density.
• During the procedure, a narrow beam of low-dose X-rays will be passed through the part of the body that is being scanned.
• Typically, the duration of the scan is between 10 and 20 minutes. After completion, you will be able to return home.

Bone density result

The results are often expressed as Z-score and T-score. Among these two, the T-score is typically the more significant. T-scores are usually negative or in the minus range.

The lower the T-score for bone density, the higher the risk of fracture. The T-score of individuals with normal bone density is between +1 and -1.

7. Colorectal (Colon) Cancer Screening

Colorectal cancer screening involves tests that can detect early signs of colorectal cancer (cancer of the colon or rectum).

Early detection can improve the chances of successful treatment and survival. Depending on their risk for developing colorectal cancer, adults should get a colorectal cancer screening at age 45 or earlier.

Colonoscopy is considered the gold standard for colorectal cancer screening, as it allows for both the detection and removal of abnormal growths. It enables your doctor to see the lining of the entire colon, including the rectum. A flexible, lighted tube is inserted into the rectum and colon to look for abnormal growths or polyps that can be removed before they turn into cancer.

Sigmoidoscopy enables your doctor to see the lower part of the colon (descending colon) and lining of the entire rectum. A short tube is inserted into the rectum to observe for polyps or cancerous masses in the rectum and lower part of the colon.

Faecal Occult Blood Test checks for hidden blood in the stool, which can be a sign of colorectal cancer. Samples of stool are collected at home and sent to a lab for analysis.

Computed tomography (CT) colonography or virtual colonoscopy is a non-invasive imaging test that uses a CT scan to create images of the colon that can be examined for abnormal growths or polyps.

Make an Appointment at Gleneagles Hospitals

Gleneagles Hospitals provides an extensive selection of health screening programs tailored to the unique requirements of each individual, considering their health condition and preferences.

Our team of dedicated healthcare professionals is available to offer guidance and assist in recommending or customising a screening package that suits your age, gender, family background, and medical history.

For appointments, please contact the Health Screening Centre at your nearest Gleneagles Hospital.