Preventing health problems during adulthood

Depending on the frequency, amount and extent of drinking, alcohol can lead to the development or aggravation of many diseases, including several types of cancer, pancreatitis and cirrhosis.

It can also cause accidents and serious psychosocial problems, such as alcohol use disorder (alcoholism).

Ask a healthcare professional to guide you toward low-risk consumption and, if necessary, toward appropriate resources that will help you get there.

For further information:

• Partying and getting drunk
  Centre for Addiction and Mental Health
• 811 phoneline: Info-Santé (option 1) or Info-Social (option 2)
• Alcohol – Drugs: Help and referral
  Phone line 24/7 (1-800-265-2626), chat and community resources referrals
• Consumption of alcohol and other drugs, and gambling

The aorta is the body’s largest artery, and carries blood from the heart through the stomach (abdomen) to the legs. Sometimes, whether because of advanced age, smoking or hypertension (high blood pressure), the wall of the aorta may weaken and swell. The swollen wall, called an aneurysm, risks rupture, causing an often fatal hemorrhage.

Abdominal aortic aneurysm (AAA) screening is recommended for all men between 65 and 80 years of age, whether they have been smokers or not. This screening is undertaken just once, using abdominal ultrasound. Screening only takes a few minutes and causes no adverse effects. Studies suggests that women need not be screened, whether they have been smokers or not, since they are less at risk.

To help you decide whether to participate in AAA screening or not, a doctor or specialized nurse practitioner can explain the advantages and disadvantages of being screened or not.

For further information:

Patient Tool – Benefits vs Harms
Canadian Task Force on Preventive Health Care

For further information:

• Colorectal cancer (colon and rectum)

Prostate cancer is the most common cancer in men. However, most prostate cancers grow slowly and only a small proportion of men who get it die from it.

Prostate cancer can be detected by taking a blood sample and measuring the prostate-specific antigen (PSA). However, routine screening is not recommended in every man.

If you are between 55 and 69 years old and you want to be screened, talk to a doctor or specialized nurse practitioner to find out the pros and cons. The healthcare professional can then prescribe the test. A decision-making tool such as the Decision Box can also help you understand the issues better.

Adopting healthy lifestyle habits can prevent several cancers and chronic diseases. In particular, achieving and maintaining a healthy weight can prevent prostate cancer.

If you notice a recent and persistent change in your urinary habits, consult a doctor or a specialized nurse practitioner without delay. They will be able to make a diagnosis, tell you what to do and, if necessary, refer you for specialized care.

For further information:

• Prostate Cancer—1000-Person Tool
  Canadian Task Force on Preventive Health Care

Cervical cancer is caused by certain types of human papilloma virus (HPV). The virus is spread mainly through sexual contact. It can cause lesions in the cervix that gradually turn into cancer. The HPV screening test (HPV test) or the Papanicolaou (Pap) smear test, which is conducted during a gynecological exam, can detect cervical cancer in its early stages, so it can be successfully treated.

In 2022, the Minister of Health announced that the HPV test would gradually replace the Pap test. In regions of Québec where the HPV test is not yet available, the Pap test is still recommended for cervical cancer screening.

HPV and Pap tests are recommended for anyone who is or has been sexually active. Screening with the HPV test is offered to women between the ages of 25 and 65, every 5 years. The Pap test is offered to women between the ages of 21 and 65, every 2 to 3 years.

To support you in your decision to participate in cervical cancer screening or not, a health professional can discuss the advantages and disadvantages of participating with you. In addition, the health professional can tell you how to prevent this cancer, perform the test and recommend vaccination against HPV, as needed.

For further information:

• Cervical cancer

Lung cancer is the most diagnosed and most fatal form of cancer in Québec. For people who smoke, it is strongly associated with smoking. A screening test may be offered to people aged 55 to 74 who:

• have smoked for at least 20 years on a continuous or non-continuous basis;
  or
• have been smoking for at least 20 years, continuously or intermittently.

If you meet these criteria and you are insured by the Régie de l’assurance maladie du Québec (RAMQ), learn the benefits and the limitations of participating in the screening test.

If you are interested in the screening, see the lung cancer screening section.

If you smoke or stopped smoking recently, support with quitting or avoiding a relapse will be offered to you. For further information, see the Smoking and vaping in adults section.

For further information:

• The Decision aid tool for Lung Cancer Screening in Quebec
• Lung cancer screening
• Smoke free lifestyle
• Personalized and free support methods to quit smoking or vaping on tobacco free Québec

Breast cancer is the most frequently diagnosed cancer in Canada, and the second leading cause of cancer death in women, after lung cancer.

Mammography can detect breast cancer at an early stage, offering a higher success rate for treatment. As part of the Québec Breast Cancer Screening Program, this examination is offered every two years to people aged 50 to 74, registered as women with the Régie de l'assurance maladie du Québec (RAMQ) and who have no personal history of breast cancer. The PQDCS is particularly aimed at people who have no symptoms of breast disease, or who are not at increased risk of breast cancer (for example, a family history or radiotherapy, or a genetic mutation).

Those eligible for the program receive a letter of invitation that serves as a prescription for a mammogram at a designated screening center (CDD), but participation in PQDCS breast cancer screening remains voluntary. To find out more about the advantages, disadvantages, and limitations of breast cancer screening, go to Breast cancer screening. People who do not wish to participate in the PQDCS can have a screening mammogram with a prescription from a physician or specialized nurse practitioner. Transgender or non-binary people can access mammography with a prescription from a physician or specialized nurse practitioner.

People who have already had breast cancer need personalized medical follow-up tailored to their situation.

To learn more:

• Breast cancer screening

• Québec Breast Cancer Screening Program

• Breast cancer – Decision support tools
  40-49 years, 50-59 years , 60-69 years , 70-74 years 

Canadian Task Force on Preventive Health Care 

For further information:

• Diabetes
• FINDRISC Risk calculator for patients
  Canadian Task Force on Preventive Health Care (CTFPHC)
• Healthy lifestyle habits
• What is diabetes
  Diabetes Québec
• Diet
  Diabetes Québec
• Physical activity: recommendations for adults
  Diabetes Québec
• Diabetes patient FAQ
  Canadian Task Force on Preventive Health Care (CTFPHC)

For further information:

• Healthy lifestyle habits
• Do you know your cardiovascular age
  My health checkup
• Improving your health through physical activity
• Canadian 24-Hour Movement Guidelines
  Canadian Society for Exercise Physiology
• Mediterranean diet
  Institut de cardiologie de Montréal

For further information:

• Healthy lifestyle habits
• L’activité physique dans la prévention et le traitement de l’hypertension artérielle (in French only)
  Société québécoise d’hypertension artérielle (SQHA)
• Hypertension Canada’s recommended BPM devices listing
  If your health professional recommends it, you can monitor your blood pressure using a recommended device
• Mesurer sa pression artérielle à domicile (in French only)
  Société québécoise d’hypertension artérielle
  Use the digital grid with integrated average calculator.
• Monitorage ambulatoire de la pression artérielle (in French only)
  Société québécoise d’hypertension artérielle
• Les aliments influençant votre pression artérielle (in French only)
  SQHA
• Le sel élément de haute pression (in French only)
  SQHA
• Hypertension artérielle – Questions Réponses (in French only)
  SQHA

Sexually transmitted or blood-borne infections (STBBIs) can have adverse health effects and lifelong repercussions. An infected person can pass an STBBI on to their partner without knowing it, often because they don’t have any symptoms.

It is recommended that you have your sexual health assessed at least once a year by a health professional to determine if risk factors for STBBIs are present. The health professional will provide advice on how to adopt and maintain safe behaviours (e.g., condom use). They will inform you about screening for certain STBBIs and may recommend vaccines (e.g., hepatitis A, hepatitis B, human papillomavirus [HPV] and mpox [monkeypox] vaccines). If necessary, they will offer you preventive treatment if you have been exposed to an STBBI. They will also be able to support you if you have an STBBI so that you inform your sexual partners.

For further information:

• Sexually transmitted and blood-borne infections
• Screening for sexually transmitted and blood-borne infections

Excess weight (overweight and obesity) is the consequence of a number of factors, including genetics, diet, sedentary lifestyle, lack of sleep, screen time as well as the environments we live in. Even if you are well informed, well disposed and strong-willed, it is sometimes difficult to adopt behaviours that support healthy lifestyle habits on a regular basis.

Overweight and obesity are associated with a higher risk of developing health problems such as cardiovascular disease, type 2 diabetes and some cancers. Weight perception also has possible effects on self-esteem and mental health.

A health professional can help you identify the causes and possible consequences of excess weight and determine objectives with you to improve your lifestyle and manage certain risk factors, possibly including the goal of improving your weight. They will be able to discuss the advantages and disadvantages of the different options to achieve your objectives with you.

• Participate in a program of meetings with specialists in nutrition, physical activity or stress management: recommended for most people and if medications or surgery are being considered.
• Take prescription drugs to facilitate weight loss: effective in the short term, but the long-term effects are uncertain, they are expensive and are not reimbursed by the public drug insurance plan.
• Consider bariatric surgery (different operations to help you lose weight). Surgery may be necessary for severe or complicated obesity, if other options have failed. However, surgery has adverse effects and there is a long waiting list to access it.
• Using slimming products or services can be harmful to health and in most cases is ineffective in the long term.

If you are pregnant or planning to become pregnant, a health professional can help you in planning optimal weight gain to reduce risks during pregnancy and childbirth and prevent future problems for you and your child. Breastfeeding is one of the recommended preventive measures.

For further information:

• Body weight
• Canadian Guidelines for Body Weight Classification in Adults
  Health Canada
• Pregnancy Weight Gain Calculator
  Health Canada
• Healthy eating
• Canada’s food guide
  Health Canada
• Improving your health through physical activity
• Canadian 24-Hour Movement Guidelines
  Canadian Society for Exercise Physiology
• Le temps d’écran, une autre habitude de vie associée à la santé (in French only)
  Institut national de santé publique du Québec

As we age, we gradually lose some of our bone mass and strength, without feeling any discomfort. On X-rays, bones appear less dense, a condition known as osteopenia (slight loss) or osteoporosis (significant loss). This weakening of the bones can lead, either spontaneously or following a minor accident (e.g. a fall from a height or chair), to fractures (breaks in the bone) known as fragility fractures. The most significant fragility fractures occur in the hip, spine, humerus (arm bone) or wrist bones.

Between 65 and 90 for women and between 70 and 90 for men, a healthcare professional can assess your risk of fragility fracture over the next 10 years.

Whatever your level of risk, you'll get advice on recommended lifestyle changes to prevent fractures:

• adequate dietary intake of calcium and vitamin D (supplements do not prevent fractures, but may be indicated on the recommendation of a healthcare professional)

• a physical activity program specially designed for the elderly (VIACTIVE, STAND UP! Program [page in French, brochure in English]) to prevent falls

• where appropriate, smoking cessation and alcohol reduction or abstinence

If your risk is high, your health care professional may suggest that you take preventive medication to slow down the process of bone embrittlement. The recommended medications (bisphosphonates) have their advantages and disadvantages, which you should be aware of and discuss before making a decision:

• Benefits: if taken regularly for 5 years, they can reduce the risk of fracture by up to half. In fact, out of every 1,000 people taking the medication, around 25 will suffer a fracture, compared with 50 out of every 1,000 without medication. Vitamin D and calcium supplements, taken together or separately, do not protect against fractures, but may be recommended if you are taking a bisphosphonate
• Disadvantages: for some people, taking the medication can cause digestive problems, which may necessitate a change in treatment. Bisphosphonates can also cause atypical fractures of the femur in rare cases (one in 4,000 people), and osteonecrosis (destruction of the bone) of the jaw in even rarer cases (one in 100,000 people)

The decision whether or not to take medication depends on your level of fracture risk: the higher the risk, the greater the benefit. It also depends on how much you value the advantages and disadvantages of preventive medication in your life. Note that there is no right or wrong decision. The professional will guide you in your choice.

If you opt for medication, the professional will perform a bone densitometry (X-ray imaging) to measure the mineral density of your bones. This examination will confirm whether or not medication is useful and will provide a baseline value for later verification of the effectiveness of your treatment.

Ultraviolet (UV) rays can cause permanent damage to the skin and eyes. Prolonged exposure and sunburn can increase the risk of skin cancer, including melanoma, and skin aging.

Adults with the following characteristics are more sensitive to UV rays:

• pale skin that reddens quickly in the sun
• freckles
• blue, green or grey eyes
• blonde or red hair

Even for dark‑skinned adults, using sunscreen is recommended to avoid abnormal pigmentation.

Sun tanning or artificial tanning is not recommended.

Artificial ultraviolet radiation

There is no safe exposure time, interval, or distance. Artificial tanning does not have any health benefits. Any exposure to tanning equipment is carcinogenic. In addition, artificial tanning is associated with risks of burns, premature skin aging, eye inflammation and weakening of the immune system. It does not protect against the harmful effects of the sun and should not be used as a source of vitamin D. However, it can treat certain diseases under the supervision of a qualified health professional.

Natural ultraviolet radiation

It is recommended to limit sun exposure between 11 a.m. and 3 p.m. and to check the UV index when planning outings. This can be done using the World Health Organization (WHO) SunSmart Global UV app or by checking local weather forecasts. You must apply sunscreen as soon as the UV index is higher than 3. Clouds and water block only a portion of UV rays. In addition, they are reflected by snow, sand and water.

Using physical methods against UV rays is recommended. For example:

• stay in the shade or under an umbrella
• wear a wide‑brimmed hat
• wear a long‑sleeved tightly‑woven top
• wear long, light‑coloured clothing
• wear sunglasses marked “100% UV protection” or “UV 400”

In addition to physical methods, using sunscreen is recommended. It must:

• have a sun protection factor (SPF) of at least 30 and be water resistant
• be approved by the Canadian Dermatology Association
• be applied 30 minutes before going out in the sun
• be applied in the following amounts:
  • 1 teaspoon for the face and neck
  • 2 to 3 tablespoons for the rest of the body
• be reapplied every two hours or after swimming or strenuous physical activity

When you use it for the first time, test the sunscreen on a small area of skin on the forearm for the time recommended in the instructions on your product to detect a possible allergic reaction.

If you are taking medication or using cosmetics, consult a pharmacist to find out if these products can increase the skin’s reaction to the sun.

For further information

• Tanning
• Protection from the sun and UV rays
• Sunscreens
  Health Canada
• UV index and sun safety
  Environment and Climate Change Canada

For further information:

• Fiches d’hygiène de la bouche (in French only):
  Enfant de 7 ans et plus, adolescent et adulte
  Personne à haut risque de carie
  Prothèse dentaire (dentier et partiel)
  Prothèse dentaire fixe sur implants
  Prothèse dentaire amovible sur implant
  Ministère de la Santé et des Services sociaux (MSSS)
• Trouver les programmes gouvernementaux et autres solutions d’accès aux soins buccodentaires — Dentaccès (in French only)
  Ordre des dentistes du Québec
• Oral health​​​​​​​
• Find a dentist
  Ordre des dentistes du Québec
• Dental services covered by the Québec Health Insurance Plan
  Régie de l’assurance maladie

For further information:

• Smoke free lifestyle
• QUIT TO WIN! Challenge
• I QUIT NOW Text message service
  Tobacco-Free Québec
• Nico-Bar (in French only)
  Canadian Cancer Society
• Aspire à mieux (in French only)
  Canadian Cancer Society
• Electronic cigarettes

Several serious diseases can be prevented by vaccination, including diphtheria, pertussis, tetanus, measles, rubella, mumps, human papillomavirus, influenza, COVID-19. Vaccines not only protect the person who is vaccinated but also limit the transmission of diseases in the family and community.

If you had all your basic doses between 14 and 16 years of age, additional vaccines are required at age 50, 65, and 75 according to the recommended immunization schedule. Consult the Québec Immunization Program page for information and to make an appointment.

Other vaccines may be necessary depending on health conditions, lifestyle habits or exposure to certain risk factors, such as travel. In addition, any adult who has not had any vaccines, whose vaccination is not up to date or who is in doubt about it should consult a health professional to find out which vaccines are recommended and to help them make an informed decision.

For further information:

• Québec Immunization Program
• Vaccination
• Demystifying beliefs regarding the risks of vaccination
• Vaccine information sheets for the population