Bob VogelQ. I’m 55 and in my ninth year as a T4 complete paraplegic. I’m at an age where the subject of colonoscopies and PSA (test for prostate cancer) come up among my nondisabled friends. However, when I visit my primary care doc, my visits are preoccupied with issues related to spinal cord injury, and these types of tests are never mentioned.

How important are cancer screenings? Seems like I broke my back, so what else can go wrong? Also, I’m now on Medicare — does it cover these screenings? If so, how do I go about setting them up with my physician?

— Gene

A. Gene, you bring up an important point. For answers I turned to Dianna Elledge, RN, of the Craig Hospital Nurse Advice Line. She explains that wheelchair users spend so much time concentrating on the health issues that accompany SCI that screenings for common types of cancers — many of which are very treatable when caught early — can get overlooked. This isn’t just a subject for middle age; both men and women should start screening for certain types of cancers in their late teens. “One big issue in these screenings is the lack of sensation that comes with SCI may prevent a person from sensing when something is wrong,” says Elledge. “Another issue is a lack of accessible machines and offices.”

The good news for people on Medicare is the plan includes a “Yearly Wellness Exam,” which has no copay — this is important because other insurance carriers frequently follow Medicare’s lead in reimbursement. A caveat on Medicare: Be sure you are being seen for a “Wellness Exam” and not a “physical,” which will have a copay. Medicaid also covers various types of annual tests and health screenings, although it varies state by state.

It is up to each of us to ask our physicians about which health screenings we should have. “Your most important tool to ensure these screenings are done is communication with your doctor — ask them about specific tests and how often you should have them,” says Elledge.