Maintaining good health means regular checkups and screenings

As we enter the second halves of our lives, we face increasing risks for disease and physical impairment. These are simply facts of aging.

But as we enter a new millennium, we also know a great deal more about good health and how to achieve it than we ever did before.

The advances in medicine, combined with our own attention to them, promise to increase not only the length of our lives but the quality of them.

With that thought in mind, here is a checklist of typical screenings and tests that detect the most common diseases associated with aging.

But before you know what to ask your doctor to check you for, you must have a doctor.

"Many people do not have a regular physician and seek care only when they are sick," says Dr. Robert J. Weiss and Genell Subak-Sharpe in "The Columbia University School of Public Health 40(plus) Guide to Good Health"

"This is unwise and causes a lack of continuity in care, the potential for missed diagnoses and development of conditions that might otherwise be prevented through measures taken after regular screenings."

Everyone over 65, and people of any age suffering from chronic diseases such as diabetes and hypertension, should have periodic physical examinations every one or two years.

If you do not currently have a regular physician, find one. Ask friends for referrals or inquire at your nearest teaching hospital, your state's Department of Aging, or your local county medical society for physicians in the specialties you need, including general practice.

Heart disease remains the No. 1 killer of American men and women, claiming nearly a million lives each year. "Although the risk of a heart attack and other cardiovascular diseases increases with age, about one-fifth of deaths occur among people under age 65,"the book reports.

Increasingly, experts believe heart disease is not so much a factor of aging, but of lifestyle choices. Avoidable risk factors now determined include cigarette smoking, high blood pressure and high blood cholesterol.

Other possible risk factors include diabetes, obesity, sedentary lifestyle, Type A personality and stress. Blood pressure and cholesterol tests should be among those you routinely seek. If you are diagnosed with problematic levels of either blood pressure or cholesterol, treatments are available.

Cancer remains the second leading cause of death.

Still, the book notes, "the fact is, using present treatments and technology, half or more of all cancers can be cured."

And the risk of cancer substantially increases with age. As with heart disease, many factors, including smoking, alcohol, diet and overexposure to the sun, account for a majority of cancer cases. "A majority of those cases could be avoided," the book states.

Periodic cancer screening should be part of a regular health maintenance checkup.

And be familiar with the warning signs of cancer publicized by the American Cancer Society:

*Change in bowel or bladder habits.

*A sore that does not heal.

*Unusual bleeding or discharge.

*Thickening or lump in breast or elsewhere.

*Indigestion or difficulty in swallowing.

*Obvious change in wart or mole.

*Nagging cough or hoarseness.

Lung cancer kills more men and women in the United States than any other form of cancer.

But the breast is still the most common site of cancer in women and the prostate the most common site of cancer in men, according to Columbia University.

Women should perform monthly breast self-examinations and have annual mammograms after age 50.

"Men can greatly reduce their risk of death if they have regular examinations of the prostate," the book reports. "Early prostate cancer produces no symptoms, [so] early detection depends on routine screening."

Diabetes is another concern. More than 90 percent of Americans with diabetes suffer from maturity-onset diabetes, the most common form of this disorder.

Maturity-onset diabetes, also known as Type 2 or non-insulin-dependent diabetes, comes on gradually and is most common after age 40 and in those who are overweight.

A family history of the disease might also suggest you seek regular screenings for it.

Regular blood and urine testing are important in detecting Type 2 diabetes.

Women who are 65 and older need to get screened for a number of diseases, according to "The Women's Complete Healthbook," produced by the American Medical Women's Association.

Men may make a couple of substitutions on this list and find it serves them as well: In place of mammography for women, men should be screened for prostate cancer, and in place of a Pap test for women, men might be screened for testicular cancer.

Here are the screenings:

*Pap test to detect cervical cancer should be done yearly.

*Blood glucose test for diabetes, yearly.

*Mammography for breast cancer, yearly.

*Total cholesterol and HDL cholesterol. Consult physician at least once.

*Fecal test for occult blood to check for silent bleeding in digestive tract, yearly.

*Flexible sigmoidoscopy to examine the colon and rectum and signs of cancer, every three to five years.

*Thyroid-stimulating hormone test to check for thyroid disease, every three to five years.

*Hemoglobin and ferritin level to check for iron deficiency. Consult physician at least once.

Additional tests advised based on risk factors:

*Urinalysis for protein, women with diabetes.

*Skin exam, for all women, especially those with frequent sun exposure, fair skin or previous skin cancer.

*Lipid profile, for women with coronary heart disease.

*Colonoscopy, for women who have bowel or colon disease or a family history of these illnesses.

*Glaucoma, for women over 40, African Americans or those with a family history of glaucoma.