Which tests are supported for people in their 40s and which are not?
Three tests with no proven benefit in asymptomatic 40–49-year-olds
These tests are not recommended for routine testing in assumed healthy people with no symptoms or known risk factors. They may be appropriate for some people with clinical suspicion of disease or increased risk as outlined in the RACGP ‘red book’.1
Prostate cancer testing
Prostate cancer kills more Australian men than any other cancer. It can be aggressive, and early detection is vital to survival. However, routine prostate cancer testing in healthy people puts a significant proportion of men at risk of harm. Are you up to date with the evidence?
Vitamin D tests
In anything other than cases of extreme deficiency the treatment for low levels of vitamin D is increased sun exposure and/or supplementation. The at-risk population is well defined, the treatments are low risk — do you really need to perform Vitamin D tests routinely?
Thyroid function tests
There is limited evidence that treatment of subclinical thyroid dysfunction benefits the patient or prevents development of the full condition. Routine thyroid function testing of asymptomatic people may result in people taking medicines for a condition that would not lead to harm. Does this fit with your current practice?
Three tests/examinations with proven benefit in 40–49-year-olds
Regular screening for cervical cancer in women reduces the incidence of this disease. Women in their 40s should be having a pap test every 2 years.
Diabetes risk assessment
Accurately assessing patients for diabetes risk is more important than routine blood glucose testing in healthy patients.
Absolute cardiovascular risk assessment
Many CVD risk factors are additive, so assessing them individually may not accurately define a person’s actual risk of developing CVD. Assessing absolute cardiovascular risk is recommended.
For more information
- The Royal Australian College of General Practitioners. Guidelines for preventive activities in general practice (the red book) 8th edn. Melbourne: RACGP, 2012. www.racgp.org.au/Content/NavigationMenu/ClinicalResources/RACGPGuidelines/TheRedBook/redbook_7th_edition_May_2009.pdf (accessed 11 February 2013).