Annual health screening: does it do more harm than good?

17 Oct

 Just as I have asked…what to h*** is “preventive health” ? 

By  Health and lifestyle Last updated: October 17th, 2012

Researchers says annual health checks have no effect on rates of disease

Do you have an annual health check? Plenty of people do. Health screening – general checks on people who don’t have any symptoms – is widely promoted by private doctors and health insurance companies – and popular. Successful executives, who are used to being in control, understandably think of their health as another area where, if they take prudent precautions, they can minimise risks.

But are these checks a good idea? A review of the evidence published in today’s British Medical Journal confirms what many doctors (apart from the ones who are paid to do annual health checks) have argued for years: that annual health checks not only do no good, but might actually be harmful.

Researchers from the Cochrane Library reviewed 14 trials involving 182,880 people. Their findings were twofold: the health checks they studied did not reduce morbidity – the risk of illness – and they also had no effect on the risk of death.

One problem with health checks is that the really unhealthy people often don’t bother having them, the researchers say. And they are not suggesting that doctors shouldn’t screen or test patients when they suspect something is going on. They approve of targeted interventions for specific conditions.

More worrying, though, is the fact that there are the many possible undesirable effects of general checks. Stephanie Thompson and Marcello Tonelli of the Cochrane Library note that “the potential for harm is likely to exceed the potential for benefit when screening is implemented in a population where the overall risk of an unfavorable outcome is low”. You may get over-diagnosis, where the tests pick up a disease that, if it hadn’t been detected, would not have affected the quality or length of your life. Abnormal test results can also lead to the need for more tests, which means more risk, worry, lost income due to work absences, problems getting health insurance, and potentially increased healthcare costs.

The health checks studied weren’t completely useless. Some of them picked up cases of high blood pressure and raised cholesterol levels. And in some cases patients reported feeling better. But that seems to be about it. The only people who unquestionably benefit from general screening programmes are private doctors and health insurance companies.

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