This appeared a day or so ago:
Health tests to think about now, and in the
not-too-distant future
So what are
the tests available now that could save your life, as well as the tests on the
horizon that could revolutionise preventive healthcare? A doctor shares his
suggestions.
Steve Robson
5:00 AM August
24, 2025
When it comes
to our health, prevention is definitely better than cure. Fortunately modern
medicine gives us the opportunity to find many diseases in their early stages,
allowing treatment before we are affected seriously or permanently.
What, then,
are the key health checks all of us should think about – and discuss with our
doctors? I’d like to share my suggestions with you.
Australians
already are fortunate to have a world-leading set of health screening tests
freely available. Adults may participate in screening for bowel, breast, and
cervical cancer, and all newborns are eligible for blood-spot and hearing
screens.
These
national screening programs have a specific aim – to detect common and serious
conditions such as bowel cancer in their early stages. Yet there are many other
important and common health conditions for which the government does not offer
free screening programs, but for which early detection greatly improves the
outlook.
While the
national screening programs make economic sense – it is cheaper for governments
to fund the screening programs than pay for treating the established disease –
having other screening tests are much more individual decisions.
I want to
share with you some tests available now that could save your life, as well as
some tests on the horizon that could revolutionise preventive healthcare.
Deciding whether to have a screening test can be difficult
and requires a careful discussion with your doctor. Each of us has different
risk factors, life circumstances and needs. There is no single best decision.
Screening tests also carry potential harms including the cost of having the
test, or of finding something ambiguous that might lead to further tests or
unnecessary treatment.
Tests
available now
Bone
density X-ray
Osteoporosis
– thinning of the bones – is a potentially catastrophic condition that puts
tens of thousands of people in hospital every year. Almost one in six
Australians aged 70 or older is affected. Hip, wrist or spine fractures are not
only traumatic but contribute to thousands of deaths every year.
Once
osteoporosis is established it is almost impossible to reverse or even stop its
progress, making it very difficult to protect against fractures. The good news
is that osteoporosis may be prevented in many cases – but the diagnosis must be
made years early for prevention to work.
Bone-density
scans usually take less than half an hour to perform. An X-ray scanner passes
over your body as you lie on a bench, taking images of your lower back and hip
region. Like all X-rays the bone density test exposes you to radiation, but
fortunately the dose is low. For most people, any risk from this X-ray exposure
is greatly outweighed by the opportunity to prevent the complications of
osteoporosis.
Who should
think about bone-density screening? People with a family history of
osteoporosis, especially in women, are at increased risk. Smoking and long-term
alcohol consumption are also red flags, as well as conditions that lead to
immobility such as arthritis especially if there is long-term treatment with
steroids.
Some
bone-density tests are covered by Medicare, but not all. The out-of-pocket may
be close to $200 in many cases.
Dementia
screening
More than 400,000 Australians live with dementia and it is the second
most common cause of death in our country. It also is a major cause of debility
and brings disruption and sadness to millions of family members and carers.
Once established there is no known effective cure.
The absence
of an effective cure, however, does not mean that identifying dementia in its
early stages is not worthwhile. Indeed the opposite is true – there are many
effective ways of improving the outlook for people when the diagnosis is
suspected early.
A number of
relatively simple tests, such as the Addenbrooke’s Cognitive Examination
(ACE-R), have been shown to be effective in identifying the early signs.
Non-medical
treatments such as aerobic exercise and social activities may help to decrease
the risk of dementia. Picture: Getty Images
Because
dementia can be worsened by other conditions such as depression, cardiovascular
disease, or the side effects of medications, the chance to act early to slow
the course of the disease should not be missed. Even non-medical treatments
such as aerobic exercise, mental stimulation, and social activities may help
decrease the risk of cognitive decline.
CT heart
calcium score
Heart disease
is one of the most common and most serious chronic conditions and almost 60,000
Australians will experience a heart attack each year. If you have risk factors
for heart disease – such as high cholesterol, being overweight, or smoking –
then you should discuss the test with your doctor. Such a discussion should
prompt further assessment of your risk and, if warranted, referral for
screening with a CT heart calcium scan.
The test
looks for a build-up of calcium in the coronary arteries – the vessels that
supply the heart wall muscle. If these vessels become blocked the result is a
heart attack. It is a non-invasive process and involves being passed through a
CT scanner which takes images of the heart and the blood vessels that supply
it, looking for the amount of calcium in the vessel walls.
The amount of
calcium is given a score, and a high score likely will lead your doctor to
recommend more detailed review and testing. Although the test is not perfect,
the early detection of coronary artery disease can be lifesaving. The test is
not covered by Medicare and typically will cost somewhere between $200 and
$300.
Kidney
function test
Some 2.7
million Australians are living with some form of kidney disease and almost 16000 people receive regular
dialysis. Around 1000 kidney transplants are performed in Australia every year.
There are
many causes of chronic kidney disease, with diabetes accounting for almost 40
per cent of all newly detected cases. High blood pressure is also linked to
kidney conditions, as well as immune and genetic conditions. Like the other
conditions I have discussed, kidney disease is very difficult to cure once
established. Finding it early is the key to a good long-term outlook in most
cases.
A urine test
looking for blood or protein is one of three components of a kidney screening.
Picture: Getty Images
Your doctor
can arrange a standard kidney health check easily. The three components of a
screening kidney health check are blood-pressure measurement, a urine test
looking for blood or protein, and a blood test measuring chemicals such as
creatinine that become elevated early in the course of kidney disease. A kidney
health check is inexpensive and safe.
A dental
check-up
Because
routine dentistry isn’t covered by Medicare, many people see dental check-ups
as something of a luxury. Nothing could be further from the truth. Untreated
dental conditions not only threaten pain and the loss of teeth, but untreated
gum disease is associated with heart disease, dementia, and even pregnancy
complications.
Many dental
conditions progress silently, causing pain or other symptoms only in their very
late stages. For this reason each of us ideally should have a dental check once
a year, and certainly no longer than two years. Your dentist will look for
tooth decay, gum disease, and cancers of the mouth and tongue.
The cost of a
check-up with a careful tooth clean will be about $200, a little more if X-rays
are required. Looking after your teeth is a very good investment, though, and
will pay off handsomely with age. Like all preventive measures, the earlier you
can start the better the long-term benefits will be.
Tests for
the future
I have
covered screening tests that are available now and that are worth discussing
with your doctor, but what screening tests are on the horizon? What might we be
asking our doctors about in the near future?
DNA screen
The test that
everyone is talking about is DNA screen, a simple saliva test that can predict
our risk of developing a range of preventable cancers and heart disease. These
are among the most common causes of premature death in Australia, and once they
produce symptoms are very difficult to treat. Prevention of early heart attack
or aggressive bowel or ovary cancer is the only known way to ensure a good
outcome.
The
technology of the DNA screen test has already been thoroughly assessed and
established. Studies have found that one Australian in 50 carries the genes
responsible for these formidable health conditions.
The good news
is that preventative and risk-reducing measures are available for all of the
serious conditions the test might detect. Indeed, so important is the
opportunity for risk reduction that testing is best performed before the age of
40 years. Economic studies have shown that the cost of testing would save an
enormous amount of money now spent treating cancer or heart disease.
The bad news?
Even though this proven testing is available now there is no government funding
for DNA screen yet. Hopefully this will change soon and all of us will have the
chance to choose to check our risk at minimal cost in the near future.
Cell-free
DNA cancer screening
When cancer
cells divide their DNA is usually scrambled. This abnormal DNA may be released
into the bloodstream once the cells it originated in break down and die.
So-called cell-free DNA technology has been used routinely for testing in
pregnancy for years now, but could be re-purposed to seek signs of very early
cancer growth in the body. Finding abnormal DNA floating free in the
bloodstream will allow early cancerous tumours to be found – long before
development of symptoms or, indeed, before ultrasounds or other imaging tests
show an abnormality.
Detecting
abnormal DNA is now a relatively inexpensive technology and only a small amount
of blood is needed. This is an exciting space to watch and hopefully will lead
to early-stage cancer screening in the very near future.
Whole-body
scans
Scanning the
whole body with MRI has been offered as a potential way of detecting disease in
its early stages, with some celebrities and influencers promoting it.
Unfortunately it is way too early to recommend such screening at the moment –
but this could be about to change.
Using MRI
scans to look for hidden conditions in a person who otherwise seems well and
healthy is a recipe for harm as things stand. Such scans are much more likely
to detect benign conditions rather than any disease posing serious health
risks. When innocent changes are detected people are likely to undergo
potentially dangerous testing or even surgery to further investigate the
“abnormal findings”. More damage than benefit usually occurs.
Using MRI
scans on a person who otherwise seems healthy is a recipe for harm. Picture:
Getty Images
That could
change and change soon. The use of AI techniques could well help sort out the
findings to worry about and what changes could safely be ignored. Although MRI
itself is very safe, the cost presently is high and resources are limited. The
carbon footprint of such an extensive MRI is considerable too.
In the
not-too-distant future, though, and with the help of rapidly advancing AI
techniques and energy sustainability, it might well be possible to have a scan
that looks for multiple important conditions at an early stage – a concept
straight out of science fiction.
Steve
Robson is professor of obstetrics and gynaecology at the Australian National
University and former president of the Australian Medical Association. He is a
board member of the National Health and Medical Research Council.
This
column is published for information purposes only. It is not intended to be
used as medical advice and should not be relied on as a substitute for
independent professional advice about your personal health or a medical
condition from your doctor or other qualified health professional.
Here is the link:
https://www.theaustralian.com.au/health/medical/health-tests-to-think-about-now-and-in-the-nottoodistant-future/news-story/8c9d434443cd3920d1cdf68cabf4f4ca
A little list to consider if you
have some time to get a few tests!
David.