Ethnic-Specific Health Screenings

June 14th, 2015

The phrase, “one size fits all”, does not apply to health screenings.  Researchers are finding that certain ethnicities have higher prevalences of diseases and that specific screening which takes ethnicity into consideration is important.  Here are some recent guidelines which I incorporate into my practice.

• Asians and Asian Americans:  BMI (Body Mass Index) cutoffs are lower.  Overweight is considered a BMI 23-26.9, above 27 is considered obese.  For Caucasians and African Americans, overweight is considered a BMI 25-29.9, and above 30 is considered obese.  What this means is that an Asian person with a BMI of 23 should be screened for diabetes, hypertension and hypercholesterolemia yearly and encouraged to lose weight through diet and exercise.  Asians and Asian Americans are at higher risk for developing diabetes than other ethnic groups, even if they don’t appear to be “overweight” physically.  The cause is not known, but experts cite environmental and genetic factors.  Here is a link to the Joslin Diabetes Center, Asian American Diabetes Initiative about the topic.
• Hispanics:  As with Asians, Hispanics are at much higher risk of diabetes.  Here is a link to the American Diabetes Association with information on screening and prevention.
• African Americans:  Colon and prostate cancers often appears earlier in this population.  Current recommendations are to start earlier screening from the America College of Gastroenterology and the American Cancer Society are to start screening at age 45 rather than 50 for other populations.  Screening for colon cancer usually consists of a procedure called a colonoscopy, while prostate cancer screening consists of an educated discussion with the healthcare provider about the possibility of tests such as a PSA (prostate specific antigen).  Breast cancer incidence in African American women is lower, but mortality from dying from breast cancer is higher.  This is thought to be due to less screenings performed for numerous reasons.  Here is a great discussion about breast cancer in different ethnicities from the Susan G. Komen website.  High blood pressure is also more common among African Americans, though we are not sure exactly why.  That means blood pressure screening is very important.  Early detection is important, here is a great site from the American Heart Association about the topic.
• Ashkenazi Jewish Population:  Many genetic diseases are common in this population.  These are generally of concern when couples try to conceive.  For example, Tay Sachs disease is a fatal disease that occurs when a child is born from two parents who each have one gene for the disease (the chance is 25% for each child conceived).  Here is a link to find out more about this and other diseases in the Ashkenazi Jewish population from Albert Einstein College of Medicine.

It is always important to ask your health care provider about these and other health screenings on your annual physical exam.  If you have a family history of any diseases you may also be at higher risk and should be screened for those.  Be sure to let our provider know about them.