■ Feng Yanyan Wang Lin
The body is the capital of the revolution, and the annual physical examination has become a "health examination paper" that everyone must submit. When the health examination gradually opens the era of age grouping, how to choose various physical examination items? You know, choosing the wrong physical examination item will not only cost you more money, but also miss the problems that should be screened, resulting in a delay in the condition. This "Physical Examination Guide for Different Age Groups" is for readers to collect for later use.
The "1+X" principle is selected for the medical examination items
There is a basic principle for the selection of medical examination items. In 2014, China's "Expert Consensus on Basic Health Examination Items" put forward the "1+X" principle, which clearly distinguishes between mandatory and alternative physical examination items.
"1" is the basic physical examination item, that is, the required item, including physical examination, laboratory examination and auxiliary examination. Such as weight, pulse, blood pressure, blood routine, urine routine, liver function, kidney function, electrocardiogram, etc.
"x" is a special physical examination item, that is, an alternative item, mainly including chronic non-communicable disease risk screening and health fitness examination items, such as urine series trace protein, tumor markers, HIV, syphilis, Helicobacter pylori (breath test), HPV multi-subtype detection, 24-hour blood pressure, 24-hour ambulatory electrocardiogram, breast ultrasound, gastrointestinal endoscopy, carotid ultrasound, bone density, thyroid ultrasound, coronary CT, etc.
Highlights of physical examination programs for different age groups
So, for people of different ages, how to choose physical examination items?
【20 years old】
People over 20 years old are in the period of graduation work and increased communication, and most of them have entered the childbearing age, and their physical resistance and immunity are at a high level. In addition to the basic physical examination at this stage, more attention should be paid to the screening and prevention of infectious diseases, such as hepatitis, digestive tract infections, urinary tract infections, and reproductive system infections.
1. In the basic physical examination items, it is recommended to focus on liver function, blood routine, lung radiograph, etc.
2. In the "X" physical examination items, it is recommended to increase the screening of infectious diseases (HIV, syphilis, hepatitis B, Helicobacter pylori and other infectious indicators).
Special attention is paid to the fact that women should pay attention to the health screening of the breast and gynecological reproductive system after the age of 20, and can choose breast B ultrasound/mammography and gynecological B ultrasound. Women who have sex can do HPV test, TCT test, etc. Depending on age and health, screening for breast and gynaecological disorders is recommended at least once a year.
【30 years old】
After the first year, life is stressful, metabolism decreases, exercise is insufficient, easy to gain weight, blood pressure, blood sugar, blood lipids, uric acid are prone to abnormalities; Sedentary people are prone to problems with the cervical and lumbar vertebrae.
1. In the basic physical examination items, it is recommended to focus on blood pressure, blood sugar, blood lipids, uric acid, etc.
2. "X" physical examination items, in addition to the items of previous years, cervical spine, lumbar spine and other examination items can be selectively added according to individual symptoms. If there is an abnormality in blood glucose in the basic examination, it is recommended to check blood glucose 2 hours after meals, glucose tolerance test, glycated hemoglobin and other items. Due to the increased detection rate of thyroid nodules and lung nodules, there is a certain malignant proportion, it is recommended to increase thyroid ultrasound, thyroid function test, lung CT examination, and selectively increase tumor marker screening.
【40 years old】
People over 40 years old have entered a high-risk period of health, and people in this age group have less energy and physical strength than before, and they have begun to experience "cliff-like aging". The incidence of chronic non-communicable diseases has increased, cardiovascular and cerebrovascular diseases have begun to age, and the proportion of malignant tumors has increased. At this stage, it is especially necessary to monitor blood pressure, blood sugar, blood lipids, uric acid, be alert to the occurrence of cardiovascular and cerebrovascular diseases, and do a good job of tumor screening, especially for high-risk groups with family history.
1. In the basic physical examination items, it is recommended to focus on electrocardiogram, blood lipids, blood pressure, blood sugar, uric acid, etc.
2. In the "x" physical examination project, on the basis of the previous physical examination items, it is recommended to focus on the investigation of cardiovascular diseases and tumors, and can choose coronary CT and lung CT examination, and selectively increase carotid B ultrasound, urinary B ultrasound, tumor marker screening, cranial magnetic resonance, etc.
Middle-aged women should focus on gynecological diseases, and can choose breast ultrasound or mammogram to screen for breast cancer, HPV+TCT cervical cytology to screen for cervical cancer, gynecological ultrasound to screen ovarian cysts, ovarian tumors and uterine fibroids, uterine tumors, etc. Menopausal women can select 6 hormones to detect hormone levels to provide a basis for clinical drug intervention.
【50 years old】
Since the age of 50, the human body function declines, in addition to the above problems to pay attention to, but also pay attention to gastrointestinal problems, bone problems.
1. In the basic physical examination items, it is recommended to focus on electrocardiogram, blood lipids, blood pressure, blood sugar, uric acid, stool routine + occult blood, etc.
2. In the "X" physical examination items, in addition to the items that should be examined over 40 years old, it is recommended to add tumor marker detection, gastroscopy, colonoscopy, bone density examination, cerebrovascular risk examination (carotid ultrasound, transcranial Doppler, etc.). Gastrointestinal endoscopy is recommended every two to three years in the general population; For high-risk people with past medical history or family history, gastrointestinal endoscopy is done annually.
【60 years old】
For those over 60 years old, it is recommended to have a comprehensive major examination at least once a year.
These divisions according to age are only a general conceptual range, specific to individuals, and must be analyzed according to the situation in order to give personalized advice. In addition to screening for common diseases, the general population should also pay attention to the screening of hearing and vision; From a young age, it is necessary to pay attention to exercise and calcium supplementation to prevent problems such as bone ligaments in old age. These small problems often greatly affect our quality of life. Female friends can choose to inject HPV vaccine, etc., to prevent and reduce the risk of some tumors. Be the first responsible person for your own health, and wish you a healthy and happy life.
(The authors all work in the Health Management Center of Shanghai Xinhua Hospital)
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Quick questions and answers about medical examinations
Q: Is the "cancer prevention physical examination" a waste of money? What age group is appropriate?
A: "Cancer prevention physical examination" is not a waste of money. Although the recommended age of early cancer screening in the world is over 50 years old, due to the continuous reduction of the age of onset in recent years, the greater the health awareness of the group, the earlier the problem is detected, the greater the benefit, so it is recommended that the age of accurate early cancer screening is after the age of 40, pay attention to screening lung cancer, stomach cancer, bowel cancer, liver cancer, breast cancer, uterine cancer, prostate cancer and other high-incidence cancers, especially people with past medical history, family history and high-risk factors.
Q: What should people of different ages check the most?
A: To sum up, over 20 years old, infectious diseases; Over 30 years old, blood pressure, blood sugar, blood lipids, uric acid, cervical spine, lumbar spine, thyroid, lungs; Over 40 years old, cardiovascular and cerebrovascular diseases, tumor screening; Over 50 years old, in addition to the above items, screening for gastrointestinal diseases and bone diseases; Over 60 years old, comprehensive screening.
Q: Is a gastrointestinal endoscopy worth it? How often is it done?
A: The target population of gastric cancer screening in China is defined as a person ≥ 40 years old and meets any of the following items, which is recommended as the target group of gastric cancer screening: people in areas with high incidence of gastric cancer, Helicobacter pylori infection, past history, family history, and other risk factors for gastric cancer (such as intake of a high-salted diet, smoking, heavy drinking, etc.).
The age of colon cancer colonoscopy screening is generally set at more than 50 years old, but the onset of colon cancer is younger, often asymptomatic in the early stage, and so on is often found in the middle and advanced stages, so it is recommended that the age of colonoscopy screening can also be advanced to 40 years old, especially if there is a family history, previous tumor history, history of intestinal diseases, unhealthy lifestyle (smoking, less exercise, overweight, high-protein and high-fat diet, lack of dietary fiber, etc.).
Screening found no obvious problems, gastrointestinal endoscopy every 5-10 years, 1-3 years for those with problems.
Q: Should I see the diseases detected, especially those marked for follow-up?
A: Marking follow-up generally refers to the condition that the condition is relatively stable or the current condition is relatively mild. Whether or not to go to the clinic depends on the specific situation.
For example, chronic pharyngitis follow-up, hypertension control is relatively stable, etc., do not go to the outpatient; Tiny nodules in the lungs, if found for the first time, there are different outpatient follow-up paths according to the characteristics of the nodules, if there is almost no change over the years, you can not go to the outpatient, annual follow-up can be.
Of course, the condition is developing and changing, and if there are uncomfortable symptoms, it is recommended to see a specialist clinic in time. The health management center has post-examination outpatient services, which can also help the medical examiners clarify the direction of follow-up.
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