Jean Darnell's reminder for a pap test arrived in the post the other day, prompting the 45-year-old receptionist to make an appointment with the doctor. “While I'm there, I might as well get my cholesterol read again,” says Darnell, who always comes in with a highly inflated reading. “I'll get them to check my breasts for any gremlins, what with Kylie's scare, but that should do it. I just had a free flu shot at work so I'm not expecting any trouble this winter.”

Over to her colleague, Derek, celebrating his 50 th birthday in the staff room kitchen where he tucks into a thick slice of chocolate mud cake. A protruding belly, ruddy complexion and slight wheeziness might – to an outsider – group Derek in a high risk category for heart disease, but there's no way he wants to be told this.

“I only have to go near a doctor's surgery and my blood pressure goes up,” says Derek. “What's the point? I'd never get a true reading. I'm not doing too badly anyway. I play tennis every Saturday and I wouldn't be able to hold up my end if I wasn't fit now would I?”

Male logic has kept Derek and half the population away from a GP for most of their adult life. Between the ages of 30 and 65 consultation rates are two-thirds women, says Professor Leon Piterman, head of General Practice at Melbourne University.

According to Professor Piterman, women go to the doctor regularly from the age of 30 for contraception, pap smear tests and assorted gynaecological issues. “There are no parallels in men so they don't turn up regularly,” he says. “Those at risk of developing cardiovascular disease are not picked up. If they were attending routinely there would be an opportunity to discuss a range of issues.”

Part of the reason is that tests for some serious conditions, such as prostate cancer, can be confronting.
But the feeling of ‘dis-ease' at potential disease, can also stop women from checking out big and little concerns, such as the arrival of a strange mole on their forehead.

It may come down to your particular health personality, as outlined by an American health and wellness research firm (Natural Marketing Institute) who, after surveying more than 2000 households, arrived at five typical health profiles. Which best describes your outlook?

Food Active: You believe health is based on eating nutritious food and getting plenty of exercise. 26%.

Well Beings: As above, but you also take supplements and sign up for courses such as meditation, Tai Chi, Pilates. 23%

Eat, Drink and Be Merry: While pouring that third glass of red wine, you have been heard to say, ‘We've all gotta die sometime'. Slightly hedonistic tendencies. 21%

Fence Sitters: You're Neutral about most health issues. You know you could make more healthy choices, but you just never get round to it. 18%

Magic Bullets: You are looking for that one pill, diet, regime that will fix all your particular health issues. 12%

The first two types are more likely to consider alternative and complementary health while the latter opt for conventional health care and prescription drugs. Whatever your choice of staying healthy, both conventional and alternative health practitioners agree that prevention is better than cure.

In Australia, more than 25 per cent of cancer cases and more than 7600 cancer deaths are attributed to excess weight and obesity, physical inactivity, poor diet and drinking alcohol. “The number of cancer deaths could be almost halved by the implementation of effective cancer prevention programs,” advises the Cancer Council of Australia.

So, take a look under your bonnet. Don't wait for the wheels to fall off, the radiator to overheat or the electronics to short circuit. Treat your doctor and/or natural health therapist like your motor mechanic and book yourself in for a service if you believe you might need to address health issues. What should you look out for? We've suggested some common checks here with additional information provided in our health check guide a table of health checks relating to age and stage of life. Print it off and insert into your diary to ensure you sign off on major health issues.

Well Women Checks

Breast awareness: With the recent publicity over singer Kylie Minogue's breast cancer, women are well aware of the need to undertake breast self-examinations regularly. Be on the lookout for any changes to your breasts, says the Cancer Council of Australia. Report any changes to your doctor immediately. Women aged 50 to 69 are eligible for a free two-yearly mammographic screening.

Click on the link below for the Council's detailed look at breast awareness in this PDF titled Early Detection of Breast Cancer.

http://www.cancer.org.au/documents/Early_detection_breast_cancer_%20MAY04.pdf

Sexually transmitted diseases: Women should also start having checks once they become sexually active and every two years after that, says nurse Helen Johns from the Royal Women's Hospital Information Centre.

Pap smear tests: Cervical cancer is the eighth most common cancer in women and one of the most preventable. Women should have their first Pap smear around age 18 to 20 or a year or two after first having sex, whichever is the later. They should continue throughout their life until age 70. Click on this link for more information about the National Cervical Screening Program.

http://www.cervicalscreen.health.gov.au/facts/index.html

Heart disease: Keep in touch with your risk status with regular consultations with your doctor and regular measurements of cholesterol and blood pressure.

Well Men Checks

Prostate health: Check from the age of 50. Click on the link below to learn more about prostate health.

http://www.prostatehealth.org.au/perl/repat?event_id=16

Testicular awareness: Testicular cancer is the second most common cancer in men aged 18-39, witness the case history of six-time winner of the Tour De France, Lance Armstrong. With early detection the cure rate is over 95%.

Heart disease: As above.

Family History
More specific testing should be based on family history. For instance, if your father died of bowel cancer at 55, start having checks for this condition 10 years before that age and every five years thereafter. If you had high cholesterol, you would book in for repeat tests every 3-6 months.

Warning Signs for Heart Attack or Stroke

According to the American Heart Association, the following warnings are likely to signal a Heart Attack:

• Uncomfortable pressure, fullness, squeezing or pain in the centre of the chest lasting more than a few minutes.
• Pain spreading to the shoulders, neck or arms.
• Chest discomfort with a lightheaded feeling, fainting, sweating, nausea or shortness of breath.

One or more of the following could signal a Stroke:

• Sudden numbness or weakness of face, arm or leg, especially on one side;
• Sudden confusion, trouble speaking or trouble understanding;
• Sudden trouble seeing in one or both eyes;
• Sudden trouble walking, dizziness, loss of balance or coordination;
• Sudden, severe headache with no known cause.
  

Warning Signs for Cancer

• Unusual discharge or bleeding
• Any unexplained change in toilet habits
• A lump in the breast, neck, armpit or anywhere else in the body
• New skin spots, or a spot or mole that has changed in size, colour or shape

Useful websites and resources

www.betterhealth.vic.gov.au

http://www.cancer.org.au/default.cfm

www.andrologyaustralia.org

http://my.webmd.com/medical_information/condition_centers/default.htm

Succesful Ageing by Robert Gingold (Oxford University Press).

The Women's Health Assessment Clinic at Melbourne's Royal Women's hospital is a free service for all women, providing total gynaecological and general health assessment. Ph: 03 9344 2531.