Periodic health assessment | The calendar of investigations according to age and sex

• The increase in life expectancy and the aging of the population have intensified the efforts in the area prevention of chronic diseases and their management when they appear.
• A better understanding of the risk factors in the development of some pathologies, together with scientific and technological progress, have also contributed to the development of effective prevention strategies.
• Chronic medical conditions (with long evolution) put a huge pressure on the health systems, and medical prevention has substantially reduced costs.
• Recognizing the importance of mental health and the quality of life of an individual in the general well-being supports promoting responsible health behaviors.

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Health statistics in Romania

right The profile of the country in terms of health, developed by the European Commission in 2023, the average life expectancy at birth in Romania was 75.3 years (in 2022).

• 71.5 years for men
• 79.3 years for women.

Risky behaviors in terms of health (smoking, alcohol, poor nutrition) have a major contribution to the occurrence of diseases and premature deaths. In Romania:

• RATES smoking daily for adults is equal to the EU average, approx. 1 in 5 people smoked regularly in 2019
• 35% of people reported a excessive alcohol consumption at least once a month in 2019, which is almost double the EU average.
• The level of obesity for adults it is at 11%, the percentage being among the lowest in the EU.

In 2020, cardiovascular diseases were the main cause of mortality in our country (55.2%):

• 18.8% ischemic heart disease
• 13.9% stroke.

Cardiovascular pathology is followed by tumor pathologies (cancer), recording the following percentages:

• 3.2% lung cancer
• 2.2% colorectal cancer
• 1.2% breast cancer
• 1.0% stomach cancer
• 0.8% prostate cancer.

Behavioral and environmental risk factors are the cause of more than half of all deaths. Approximately 46% of all deaths registered in Romania in 2019 could be attributed to behavioral risk factors, such as tobacco consumption, food risks, alcohol consumption and reduced physical activity.

• Food risksincluding high levels of sugar and salt consumption, as well as low fruit and vegetable consumption, were associated with 25% of all deaths in 2019.
• Tobacco consumption (including passive smoking) contributed to approximately 17% of deaths.
• 7% were assigned alcohol consumption
• 2%, low levels of physical activity.

Air pollution, in the form of exposure to ozone and fine particles of matter (PM2.5), contributed to approximately 7% of deaths in 2019.

Education and information about risk factors

Informing and educating the patient is the first step in a solid partnership for health.

Cardiovascular diseases are a major public health problem, not only in Romania, but globally. It is necessary to provide information on the risk factors for cardiovascular diseases, to provide recommendations regarding a healthy lifestyle, to present the risks associated with smoking and alcohol consumption. Learn more about the most important steps we can take to keep our hearts healthy and how we protect our cardiovascular health

Also, in the context of the increase in the incidence of malignant pathologies, education about the risk of cancer depending on age, sex and family history and information about the screening calendar for the early detection of cancer.

Find out about screening tests for early stage cancer detection

Periodic evaluation of women’s health | The calendar of investigations according to age

• After the age of 55, a specialist consultation is recommended annually to identify symptoms that could be suggestive of transient ischemic attacks.
• Checking blood pressure is recommended as a simple routine measure, starting with adulthood (from 18 years).
• Measuring weight and height, determining abdominal circumference and Body Mass Index is recommended to be done annually, starting from the age of 18.
• Cardiovascular risk assessment using the SCORE scale is recommended every 3 years, starting from adulthood.
• Annually, also from the age of maturity, the dermatological examination of the oral cavity, lips, pharynx, lymph nodes and thyroid gland is indicated.
• Annual gynecological and breast examination at the specialist doctor, periodic self-examination of the breasts is also recommended.
• The Babes – Pap test (PAP) in a liquid medium or by conventional/standard cytological examination is indicated to be performed periodically with the start of sexual life, as follows:

• Age 21-29 – every 3 years
• Age 30-65 – every 3 years
• Age 30-65 – every 5 years only in the PAP and HPV co-test version
• Age over 65 years – it is recommended only in the conditions where the previous results have highlighted the existence of some anomalies.

• Mammography is recommended starting at the age of 50, with repetition every three years, for women who do NOT present symptoms and do NOT have a family history of breast cancer. In the presence of symptoms and family history of breast cancer, mammography is indicated regardless of age.
• Laboratory tests – starting with the age of 18, annually:

• blood count
• Urine summary
• Cholesterol
• Fasting blood glucose.

• After the age of 50, the investigation for colorectal cancer is indicated (annual occult blood tests or colonoscopy), with repetition every 5 years.
• Osteodensitometry (lumbar spine and proximal femur) is indicated starting with the age of 65. Bone densitometry (DXA) is the reference standard by which the most important factor in predicting fracture risk is measured – bone mineral density (respectively calcium content).
• Immunizations:

• Hepatitis B – in people at risk, vaccination against Hepatitis B is recommended, 5 years after the primary immunization if the titer of specific anti-HBs antibodies is low
• HPV vaccination is recommended before starting sexual life
• Vaccination for chicken pox (if the specific IgG is negative) can be done at any age
• Influenza vaccination – annually for all age groups.

Tests and investigations in pregnancy

If the pregnancy is NOT high-risk, standard prenatal care protocols recommend:

• Prenatal education
• Anamnesis (personal and family history)
• Recommendations regarding diet, lifestyle, work schedule and giving up alcohol and stimulants
• Discussing immunizations – flu, rubella, hepatitis B, chicken pox, whooping cough
• Supplementation with folic acid at least 2 months before pregnancy or routine
• Papanicolaou test (if it has not been performed in the last 6 months)
• Laboratory investigations:
• Blood type
• blood count
• Urine summary
• Test for toxoplasmosis (IgM, IgG antibodies)
• Rubella test (IgG antibodies)
• Hepatitis B (HBs antigen) and hepatitis C (anti HCV antibodies) test
• HIV test
• RBW test (syphilis).

To monitor the evolution of the fetus, follow-up ultrasounds of the pregnancy and fetal morphologies in the first and second trimester are indicated.

Periodic evaluation of men’s health The calendar of investigations according to age

• After the age of 55, a specialist consultation is recommended annually to identify symptoms that could be suggestive of transient ischemic attacks.
• Checking blood pressure is recommended as a simple routine measure, starting with adulthood (from 18 years).
• Measuring weight and height, determining abdominal circumference and Body Mass Index is recommended to be done annually, starting from the age of 18.
• Cardiovascular risk assessment using the SCORE scale is recommended every 3 years, starting from adulthood.
• Annually, also from the age of maturity, the dermatological examination of the oral cavity, lips, pharynx, lymph nodes and thyroid gland is indicated.
• Laboratory tests – starting with the age of 18, annually:

• blood count
• Urine summary
• Cholesterol
• Fasting blood glucose.

• After the age of 50, the investigation for colorectal cancer is indicated (annual occult blood tests or colonoscopy), with repetition every 5 years.
• After the age of 50, the PSA test is indicated as a prostate cancer screening method.
• Immunizations:

• Hepatitis B – for people at risk, vaccination against Hepatitis B is recommended, 5 years after the primary immunization if the titer of specific anti-HBs antibodies is low
• Vaccination for chicken pox (if the specific IgG is negative) can be done at any age
• Influenza vaccination – annually for all age groups.

Medical prevention means constant investment in our health and involves a proactive attitude in maintaining physical and emotional well-being. Promoting prevention methods and access to quality medical services substantially reduce the risk of disease occurrence and improve the quality of life.

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