Sharpen your pencils and take note of the health-care screenings you need to schedule in the year—and years—ahead.

By Dr. Saima Jehangir, Photo by Sherry Hammond Photography

It’s an old adage we’re all familiar with: A stitch in time saves nine. And though an unraveling hem and your health may not seem to have a lot in common, in fact, they do. Early detection of an unraveling health condition can allow for early intervention, leading to a better outcome.

Screening tests are, by nature, meant to be affordable and available to large populations and sensitive enough to detect disease. The downside, of course, is false positives, but when patients are educated about the management of a positive test, these tests can be a source of reassurance and relief rather than a burden.

So, what screening tests do you need? Let’s start with the tests and visits that offer the biggest bang for your buck.

Pap smear with HPV testing

This is probably the test that causes the most confusion among patients, but it’s the single cheapest life-saving screening test in the history of women’s reproductive health. Pap smears have dropped the percentage of deaths due to cervical cancer by 70 percent or more since the test’s introduction into routine screenings.

To be started at age 21, or three years after a woman becomes sexually active, the test can be repeated every one to three years, depending on the patient’s risk factors and whether she’s a carrier of HPV. A woman is considered at high risk if she has had more than five sexual partners in her lifetime, and should be screened yearly. Also, women who are sexually active should be tested for sexually transmitted diseases when between partners, regardless of whether they have a pap smear at the same time. These tests can be performed on urine samples and do not always require a pelvic exam.


Once again, there’s so much confusion surrounding mammograms and when to start getting the test. Screening should start between the ages of 40 and 45 and continue yearly unless the patient has a family history of breast cancer, in which case, the screening schedule should be modified, with screening starting, in some cases, as early as age 30. Family history also contributes to whether a woman should be tested for inherited cancer syndromes. Those who carry a genetic mutation may have a screening schedule that’s altered from that of the general population.


Much like the vagina, women cannot examine our own colons and therefore, a doctor needs to. Routine colonoscopies should begin at age 50 unless there’s a family history of colon cancer or the patient carries a genetic mutation. The screening is good for 10 years unless otherwise recommended by your doctor.

Skin exam

All those years of tanning with baby oil may be catching up to you. And allowing a dermatologist to examine what seems simply like dark moles and freckles may just save your life. Skin exams should be performed yearly.

Blood work

Yearly blood work can detect blood disorders, high cholesterol, abnormal liver and kidney function, diabetes and thyroid dysfunction. Most all of these conditions are treatable with simple lifestyle modifications or medical management. Performing blood work yearly also allows for a comparison point if lab results do become abnormal at some point.

How to Access Affordable Health Care

With insurance deductibles high and many patients uninsured, the question of how to obtain affordable testing always arises. Austin is lucky to have many reduced-cost resources and physicians willing to work toward keeping the population healthy.

Most insurance plans cover one preventative visit per year. Don’t waste this annual opportunity to discuss any health-care concerns.

>> If you are in between insurance plans and have seen a physician before, consider returning to her. Most offer a lower cost cash-pay visit to established patients. Otherwise, higher cost procedures can be placed on a payment plan with most offices.

>> Both Planned Parenthood and Lone Star Circle of Care offer low-cost health care, often based on a sliding scale determined by yearly income.,

>> Mammograms are also available with cash payments at most local radiologist offices.   Seton’s Big Pink Bus offers free mammograms to women older than 40 who qualify.

>> If you are a resident of Travis County, you may qualify for the Medical Access Program, which gives patients access to affordable health care.

>> There are many clinical trials available in Central Texas to treat various conditions. This is great way to access free diagnosis and treatment and be compensated for your time.


Dr. Saima Jehangir is a licensed gynecologist at Lotus Gynecology, Health and Wellness,


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