A Summer Assignment
College kids need a physical, too, and now's a good time
Teasing out how a student balances his work-study job with that crush of English papers, for example, may reveal that he's been pulling all-nighters with the help of his roommate's Ritalin. A probing discussion of how a young woman manages her feelings of loneliness can uncover signs of an eating disorder, suicide risk, or substance abuse. Finally, the conversation should cover how often your child chooses a side of vegetables over fries, and whether the IM'ing ever stops long enough to allow time for exercise.
In addition, a range of lab tests may be called for—though families may well have to request that the doctor offer them. "A lot of parents don't want to believe their child may be having sex," says Cynthia Burwell, chair of Healthy Campus 2010, the American College Health Association's initiative to get college administrations to promote healthful choices by students. But STDs are a real risk, and a full work-up is not standard practice. The rate of infection with gonorrhea or chlamydia, each of which can result in lasting pain and infertility if untreated, is higher between the ages of 15 and 24 than in any other age group.
Screening for both can now be performed using a urinalysis, good news for young men whose only option used to be an uncomfortable swab inside the urethra. (Some doctors still use the old technique, so a call ahead may be in order.) Syphilis and HIV testing is typically done with a blood test, but saliva tests for HIV are available. By the time a patient is 18, privacy laws prevent doctors from sharing his or her health records without permission, so there's no need to fear that a disapproving parent will be clued in.
Cancer check. A genital exam is also key. Young men should be checked by a doctor for testicular masses; the cancer is rare, but early treatment yields a very high cure rate. According to the National Cancer Institute, young women should have their first Pap smear about three years after first having sex but no later than age 21. The test should detect abnormal cells or HPV, the virus that can lead to cervical cancer. Because the cancer is very rare in women under age 25, waiting up to three years between tests may be acceptable. Earlier is better with Gardasil, the HPV vaccine, but it can be administered for girls and young women up to age 26.
Anyone battling the "freshman 15" might want to add a blood-glucose screen. Research published last week in the Lancet suggests that type 2 diabetes is a serious and growing problem in teens and that they are not getting screened appropriately. Stanley Mirsky, associate clinical professor of metabolic diseases at Mount Sinai School of Medicine in New York and a member of the board of overseers of the Joslin Diabetes Center in Boston, would advise a test for someone with any of the following: a family history of diabetes, an extra 5 to 10 pounds, or a couch-potato lifestyle.
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