What to know about physicals, including when to start getting them and how often to see a health-care expert

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle.

Just like that, it can seem like your next annual physical exam is right around the corner. Or maybe you've never had a medical professional assess your overall health and you're wondering if a physical is worth the time.

Modern health care is more personalized than ever, and that includes the classic checkup. Below, find out if you're getting a physical as often as you should — and whether you should bother booking an appointment with your local expert.

What is a physical?

A physical is a routine medical exam to check your general health, look for signs of disease and ensure you have a healthy lifestyle. They're often completed by doctors, but other health-care professionals like nurses and physician assistants might also perform a physical.

Overall, a physical lets a health-care provider evaluate your body by looking, feeling and listening. It's typically a quick routine exam — often lasting only around 30 minutes — that helps prevent future medical problems or concerns.

What happens during a physical?

A physical usually involves an interview and a hands-on examination. If your appointment is with a health-care expert you haven't seen before, they might ask you about your medical history, including your conditions and treatments. They'll probably also ask about your family history.

Once they have up-to-date information, they'll ask you how you've felt since your last visit. That might include questions about:

• Recent and current symptoms

• Medications and supplements

• Lifestyle and daily habits, including exercise, diet and substance use

• Mood and any mental health concerns

The next part is a physical examination. The person performing the exam might assess the following parts of your body:

• Skin

• Eyes and ears

• Nose and mouth

• Heart

• Lungs

• Abdomen

• Feet

• Nervous system

Depending on your age, your physical will also involve routine screening for certain conditions such as cancer and high blood pressure. You might also receive a breast exam, or a scrotum, prostate and testicle exam, to check for lumps or other issues.

Why do I need to get a physical?

The main purpose of getting a physical is for a health-care expert to ensure you're in good health. If you're in poor health, a physical will allow the examiner to provide medical recommendations to help you get to a better state.

Even if you feel fine health-wise, that doesn't always mean you're completely healthy. Many chronic health conditions don't cause symptoms in the early stages, and health-care providers can help discover early signs of problems you might not even notice.

Moreover, a physical might let you stay up-to-date on immunizations. If you're missing any vaccines or if you're unsure what shots you might need, a physical will help you get on track of your health.

Finally, a physical is a perfect time to ask a health-care professional about any personal health questions or concerns you might have. For instance, if you're experiencing a symptom that might be suspicious but not overly concerning, getting a physical can help you get any answers you need.

What age should women start getting a physical?

Reproductive health is one of the most important reasons for women to get regular physicals. However, women start having these physicals at different ages. In some cases your health-care provider might have you start getting regular visits in your 20s or 30s so you don't miss important screening tests.

Missing physicals can lead to poorer health outcomes, as Canadian physicians noticed during the COVID-19 pandemic. It is advised to talk to a health-care expert about when you should start having regular visits.

Breast cancer screenings

According to the Ontario Medical Association (OMA), women missed around 422,000 routine mammograms during the height of the pandemic.

One physician from The Ottawa Hospital reported that before the pandemic, half of breast cancer diagnoses came from routine screenings. That number then dropped to 29 per cent. The remaining 71 per cent had symptoms, which means the cancer was more advanced.

More advanced cancers have a lower five-year survival rate. That's about 22 to 39 per cent at stage four compared to 98 per cent at stage zero or one, the OMA noted.

For women aged 50 to 74, breast cancer screenings are recommended by the Canadian Cancer Society (CCS). Women under age 50 with a family history of breast cancer or other risk factors should talk to their health-care providers for personalized recommendations.

Pap tests

The CCS estimated 1,600 Canadian women would receive a cervical cancer diagnosis and around 400 would die in 2024. Regular Pap tests can identify cervical cancer in its early stages. In some cases, they can even pick up on cellular changes that could become cervical cancer if left untreated.

Pap smears are recommended by the Canadian Task Force on Preventive Health Care (CTFPHC) every three years from ages 25 to 69 for women who are or have been sexually active. According to the CCS, screening should begin at age 21 if the woman has been sexually active, and will be necessary every one to three years.

Other screenings

Non-reproductive screenings are also important. Health-care professionals recommend women receive screenings for:

• Type 2 diabetes, every three years, starting at age 40

• Colorectal cancer, every two years with a fecal occult blood test or every 10 years with sigmoidoscopy (similar to colonoscopy but focusing exclusively on the lower part of the large intestine)

• Osteoporosis, routinely starting at age 65 or 50 with specific risk factors

For what it's worth, research has shown the Canadian osteoporosis screening identifies more candidates for bone density screening compared to the approach in the United States.

What age should men start getting a physical?

Just like women, men have different medical needs. On top of general screening needs for problems like diabetes and cancer, men also face sex-specific concerns including prostate cancer.

But in terms of when you should start getting physicals, it doesn't matter if you're young and in your 20s or 30s, or if you're older in your 40s or over 50, according to the Canadian Men's Health Foundation. It's a good idea to start seeing a health-care professional regularly before waiting until something goes wrong with your health.

When it comes to prostate cancer screenings, those should be offered to men with a life expectancy above 10 years, according to the Canadian Urological Association (CUA). Part of that process should include counselling patients on the risks and benefits of screening, which the CTFPHC has identified and shared with the public. They include:

• A one in 1,000 chance of receiving life-saving treatment thanks to screening

• Increased possibility of treating a condition that would not have caused suffering or death

• Potential for fatal complications from treatment

The CTFPHC also noted it believes the risks of screening outweigh the benefits, but leaves testing available for those who want it. Also, men aged 65 to 75 should be screened for abdominal aortic aneurysm if they've smoked in the past, according to the CTFPHC's recommendations.

How often should you get a physical?

As is often the case with human biology, the answer on how often you should get a physical is that depends on your body.

If that surprises you, you're not alone. People have been getting routine physicals since the 1920s when employers and insurers began ordering them in the name of "prevention." But, as we've learned more about how the body works, doctors have started questioning whether this practice is necessary or helpful.

The CTFPHC has spent a lot of time researching the routine physical. After reviewing multiple studies, it has found that annual checkups don't reduce deaths from cancer, heart disease or general causes. Results showed doctors can learn just as much from talking to patients about their habits and risk factors.

In 2017, the CTFPHC recommended eliminating complete annual physical exams in favour of periodic preventive visits. Preventive visits are scheduled meetings where a doctor can offer health counselling, routine screening tests and immunizations. These visits have proven particularly beneficial for people older than 65, according to the task force.

For people younger than 65, patients should customize the frequency of their physicals based on age, sex and health history, according to the CTFPHC.

Since everyone's screening and prevention needs are different, there will never be a correct schedule for every patient. The best strategy is to talk to a health-care provider about recommended screenings according to age group, then creating a personalized schedule for preventive care.

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