Important Medical Tests Doctors Don’t Tell You About

The special screening tests for discovering heart disease, aneurysms, lung and ovarian cancer could save your life, but your doctor likely won’t order them because insurance companies rarely pay for them. With some exceptions, such as mammograms, insurance rarely pays for screening tests aimed at early detection.

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Ask your doctor if you should have any of the following tests, even if you have to pay for them yourself. These tests are appropriate for everyone, but early research suggests that they could be lifesavers for those with key risk factors.

Cholesterol Test

Traditional cholesterol tests only measure HDL (“good”) cholesterol and triglycerides, and the formula used to calculate levels of harmful LDL cholesterol isn’t always accurate – which might explain why half the people who have heart attacks have cholesterol levels that appear normal. Expanded cholesterol tests measure LDL specifically (and individual HDL), giving more accurate readings. About 40 million American adults have hidden heart disease, and expanded cholesterol tests could identify most of them before a heart attack occurs.

Particularly at risk are patients with mildly elevated cholesterol levels (200 to 230 mg per deciliter), who smoke or who have cardiovascular risk factors, such as hypertension or a family history of heart disease. Tests range from $75 to $175 each.

Heart Disease Test

Current methods for detecting heart disease risk, such as checking blood pressure, miss up to 75 percent of patients who later on develop heart problems. A better test is the electron beam tomography, or EBT, heart scan, which is the first direct, noninvasive way of identifying atherosclerosis, the primary risk factor for heart disease. The EBT maps out calcium deposits in the arteries, which indicate potentially deadly blood clots and plaque accumulation. However, calcium deposits are sometimes harmless, and a clear scan may not mean plaque levels are low. Nevertheless, the EBT is considered useful because traditional tests don’t catch most heart problems and early detection is what saves lives. Those especially at risk for heart disease are men over age 45 and women over age 55, smokers and those with a family history of heart disease. EBT tests cost about $400.

Aneurysm Test

Aneurysms are bulges in artery walls, which can be deadly when they rupture. Nearly 30,000 Americans die from ruptured aneurysms every year. An aneurysm scan uses an ultrasound wand to detect aneurysms in the abdominal aortic arteries. It’s the only noninvasive test that allows doctors to identify aneurysms before they rupture. Surgery to repair aneurysms can increase survival rates to 99 percent. Particularly at risk are those over age 60 with cardiovascular risk factors (like hypertension), smokers, and anyone over age 50 with a family history of heart disease. Tests cost between $60 and $200.

Lung Cancer Test

Lung cancer rarely causes symptoms until it reaches an advanced stage. The 5-year survival rate is about 15%. Conventional x-rays may fail to detect early-stage tumors. The spiral CT scan, however, can detect cancerous tumors as small as a grain of rice. However, the test can result in false positives, which can lead to unnecessary procedures. Follow-up tests and scans can provide more accurate results. Current and former smokers aged 50 and over who have smoked at least a pack a day for 10 years or 2 packs a day for five years should have the test done. Tests cost between $300 and $500.

Ovarian Cancer Test

One of the deadliest of female cancers and also asymptomatic until reaching advanced stages, ovarian cancer claims the lives of more than 14,000 American women every year.  An ultrasound device inserted into the vagina allows doctors to inspect the ovaries for any malignant changes, improving chances of detection by 50%. The only drawback from this test is that it isn’t able to differentiate between malignant and benign growths, so positive test results could result in unnecessary procedures. Mostly at risk are women aged 45 and older with risk factors (like family history of ovarian, breast and colon cancer; history of fertility or hormone treatment; or who have never been pregnant). Tests cost about $250.

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