Routine tests
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Sarah* (47) had always been active. In her 30s, she ran competitively while balancing the demands of her family and working as a graphic designer.
But in her 40s, Sarah shifted focus. On the advice of her personal trainer, she took up strength training, which felt less strenuous than the intense cardio she’d practised for years. She also cut back on her working hours to concentrate on projects that interested her most.
Despite the slowdown in her pace of life, she wondered why she had no energy. Getting out of bed was difficult and by mid-afternoon all she wanted to do was lie on the couch.
This fatigue wasn’t the only symptom bringing her down. She’d been constipated for weeks, a change in her bathroom habits that had come on suddenly and was accompanied by severe cramps. She’d also lost a lot of weight – probably because she didn’t have very much appetite.
When Sarah finally consulted her GP, he advised a colonoscopy – and that’s when the mass in her colon was found.
Colorectal cancer screening
Sarah’s experience demonstrates why most doctors recommend colorectal cancer screening from age 45. “We’d recommend a colonoscopy if you have any symptoms,” says Dr Francois van Niekerk, a family doctor at Mediclinic Newcastle. “If you don’t, a faecal occult blood test is often enough.”
This test checks for hidden blood in your stool. If any blood is found, you should have a colonoscopy to find out what’s causing it. If the test is normal, you should repeat it once a year.
A colonoscopy is usually done every 5-10 years, depending on your family history.
Breast cancer screening
From age 45, women should schedule a mammogram screen for breast cancer. If the scan is all clear, the screen needs to be repeated in two years’ time – but speak to your doctor if you have a family history of breast cancer.
Cervical cancer screening
Pap smears are recommended when a women becomes sexually active and it is important to continue having them every two years – or sooner if you have any concerning symptoms such as post-coital pain or bleeding.
Prostate cancer screening
Dr Van Niekerk explains that there are different approaches to prostate screening. In men over 40 years it’s advisable to have an annual PSA screening. If PSA is raised, they should be referred to a urologist for further investigation. In the USA, annual PSA tests are generally recommended. He adds that each approach has advantages and disadvantages. If a PSA test shows abnormal results but no mass is detected, an MRI is recommended. This gives a clear view of the prostate and helps guide a precise biopsy, improving the chances of accurate diagnosis and treatment.
Skin cancer screening
A skin cancer screening is also recommended. This is especially important if you have a family history of skin cancer, or if you have many moles on your body. In this case, it’s a good idea to visit a dermatologist for annual mole mapping; otherwise, you can ask your doctor to assess your moles during your yearly check-up.
[JP1]I am not sure how to bring in cervical cancer screening. PAP smears are recommended when a women becomes sexually active. It will be valuable to mention this and that it should be continued every 2 years, or sooner if there are any concerning symptoms. These being post coital pain or bleeding, but it is not specifically for over 40s??
Healthy habits
Dr Van Niekerk says people in their forties should also watch for conditions like diabetes and high cholesterol. It’s important to exercise regularly, eat a balanced diet, get enough sleep, and manage stress to support your long-term health.
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