Naked Science Forum
Life Sciences => Physiology & Medicine => Topic started by: thedoc on 26/11/2012 16:51:59
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A systematic review of research into general health checks shows that, although they increase the number of diagnoses, they do not reduce the number of deaths from cardiovascular disease or cancer...
Read the whole story on our website by clicking here (http://www.thenakedscientists.com/HTML/content/news-archive/news/1000023/)
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Most interesting.
I've always wondered if a general physical exam was necessary for individuals who are otherwise generally healthy when a large part of the study is to ask if the patient has any "symptoms".
If one runs a panel of lab tests, it is not uncommon to find a couple of values slightly outside of the "normal" range. Then what should one do with these results? It tends to cause unnecessary worry for the patients.
There has been a lot of debate about prostate screening. Metastatic prostate cancer can be very devastating. However, a large number of 80 yr old men have asymptomatic prostate cancer contained entirely within the organ.
I would wonder, however, if this study should be separated by individual test. For example, there may be benefits of fecal occult blood testing, and periodic colonoscopy, and early removal of polyps which might otherwise be undetected.
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... periodic colonoscopy, and early removal of polyps which might otherwise be undetected.
Having a camera stuck where the sun don't shine is surprisingly expensive ...
UK prices for colonoscopy £1005- £2195
http://www.privatehealth.co.uk/hospitaltreatment/whatdoesitcost/colonoscopy/
So there would be enormous cost for everyone to have one done annually.
There is also a small risk of serious complications of colonoscopy, (e.g. bowel perforation).
https://www.ncbi.nlm.nih.gov/books/NBK6945/
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Not annually...
But, perhaps at 50, 60, 70, or so.
Sigmoidoscopy is less invasive than colonoscopy, but has the potential to miss cancer and precancer.
Good point about the risks. According to the article, somewhere about 0.2% to 0.6% of the colonoscopies result in perforation, with a resulting 3% to 10% mortality.
Of course not all polyps develop into cancer, but it is far cheaper, with better outcomes when treated early.
Overall each test should be evaluated for its efficacy. Even listening to the heart once a year adds up. What is better, $100/yr to listen to the heart for a decade, or 1 colonoscopy per decade?
A physician's assistant, or even a nurse could do routine blood pressure screening. Or, even self administered tests. Blood pressure, of course, is something that needs some monitoring in some individuals.
The HPV vaccine could reduce things like the need for a PAP smear.
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I would wonder, however, if this study should be separated by individual test. For example, there may be benefits of fecal occult blood testing, and periodic colonoscopy, and early removal of polyps which might otherwise be undetected.
This was certainly what they recommended for future research - looking at individual tests, rather than blanket screening.