Serious conditions that can be missed

Many serious conditions have vague or hidden symptoms. Here’s how to identify and screen for them.

Health Agenda
April 2017

They're some of our most frequently diagnosed illnesses, but often they have no symptoms or symptoms that are easy to miss or mistake for something else. From ovarian cancer and heart disease to diabetes and osteoporosis, here's what to look out for and the screening tests that can provide peace of mind, or an early warning.

Breast cancer

In 2016, about 16,000 Australians were diagnosed with breast cancer, including 150 men. “Possible signs include a rash on the skin of the breast, dimpling or redness of the skin, weight loss, back pain and swelling under the armpits,” says Dr Clare Ballingall, Chair of the Royal Australian College of General Practitioners Tasmania.

Screening: Free mammograms are available through BreastScreen Australia for women aged 40+ and are highly recommended for women aged 50-74. If you’re under 50 but are at high risk of breast cancer, you can get a Medicare rebate for a more accurate Magnetic Resonance Imaging (MRI) screening and/or a diagnostic ultrasound.

“If you have a first-degree relative with breast cancer you may be referred to a genetics team for your own targeted surveillance. For other women [over 40], mammograms are done every two years,” says Dr Ballingall.

Cervical cancer

Early cervical cancer rarely causes noticeable symptoms but as the disease progresses it can lead to pain during sex, spotting after sex, bloody vaginal discharge, lower abdominal pain and bleeding between periods. More than 800 Australian women a year are diagnosed.

The biggest risk factor is infection with some types of the human papillomavirus (HPV). Immunising children from HPV before they're sexually active is the best preventive measure so the government has introduced the National HPV Vaccination Program for 12-13 year olds.

Screening: From 1 May 2017, the Pap smear test, which was done every two years, will be replaced with a Cervical Screening Test every five years for women aged 25+.

Colon cancer

Colon or bowel cancer is the fourth most commonly diagnosed cancer in Australia and it's estimated 1 in 20 people will be diagnosed by the time they're 85. “There’s a crossover of symptoms of irritable bowel syndrome, such as constipation, diarrhoea, changes in bowel habits and feeling you haven’t emptied your bowels properly,” says Dr Ballingall. “Sometimes there can be mucus or blood in poo and screening can detect that.”

Screening: Current guidelines are to do a faecal occult blood test, also known as a faecal immunochemical test, every two years from the age of 45. Your GP may recommend a colonoscopy, which is where a flexible tube with a camera is used to examine the large bowel for abnormal growths.

Diabetes

Approximately 1 million Australians have type 2 diabetes and your risk increases with age. Possible signs of type 2 diabetes include getting up to urinate in the middle of the night, being thirstier than normal, sudden weight loss, fatigue and numbness of the feet. “Vision can get blurry too,” says Dr Ballingall.

Screening: Do the Diabetes Australia questionnaire, which calculates your risk for developing diabetes over the next five years. If you’re at risk, see your GP for a fasting blood glucose test. Have your eyes checked every two years to detect changes that may indicate diabetes.

Heart disease

Around 1.2 million Australians are affected by heart disease. Many risk factors are silent, such as high blood pressure and cholesterol. Breathlessness, pain between the shoulder blades, neck or throat pain, arm pain, or feeling nauseated and light-headed can also be signs of heart disease.

Screening: “From the age of 45, everyone should have a cardiovascular and blood pressure risk assessment,” says Dr Ballingall. Ask your GP to check your blood pressure, cholesterol, height, weight and waist measurement. If you're low risk and have no family history of heart attack, get checked every five years. If a close relative has died of a heart attack, get checked every two years.

HCF offers members with extras cover access to free Victor Chang heart health checks at various branches throughout the year. It only takes minutes and the results are available immediately.

Osteoporosis

According to Osteoporosis Australia, 1.2 million of us have osteoporosis and a further 6.3 million have low bone density. Bones can become brittle due to calcium and mineral loss, particularly in older women as their oestrogen levels – which help maintain the minerals bones rely on – drop with age. This increases the likelihood of breaks, particularly in the wrist, spine and hips.

While there are no obvious signs, anyone over 50 who breaks a bone during a minor bump or fall should consider being checked for osteoporosis. Early diagnosis means you can take advantage of lifestyle changes and medications that can limit the impact of the disease.

Screening: If you’re aged 50+ and have osteoporosis risk factors, your GP can refer you for a bone density scan, which measures the density of your hip bones and spine. If you meet set criteria you’ll be able to claim a Medicare rebate for the scan.

Ovarian cancer

Each year about 1,500 women in Australia are told they have ovarian cancer. The five-year survival rate for the disease is 43% (compared to 90% for breast cancer). Symptoms include bloating, quickly feeling full when you eat, back, abdominal or pelvic pain, constipation, fatigue and indigestion.

“Irregular or heavier periods can also be a symptom and if you have a first degree relative who’s had ovarian cancer, you’re at greater risk,” says Dr Ballingall.

Screening: There's no effective screening test. If you’re worried about possible signs, see your GP, who can refer you for a blood and/or an imaging test such as an ultrasound.

Skin cancer

Around two in three Australians will get skin cancer by the time they reach 70. More than 750,000 people are treated for skin cancers each year. The most dangerous form is melanoma.

“Be aware of your own skin. Look for rough skin or redness that doesn’t heal, or for a spot or sun spot that ulcerates and won’t go away,” says Dr Ballingall.

Screening: Regularly check your own skin and see your GP if you notice any changes.