Ever had a general health check? And the results came back saying everything, or almost everything, was OK?
I have. As a matter of fact, I’ve had several general health checks in my lifetime, all of which indicated comparatively minor problems, like a rise in my LDL cholesterol level or higher-than-normal uric acid levels. Nothing to make me worry about my health. I felt confident that I didn’t have cancer, significant heart disease, or anything else that might cause premature death. Obviously, in my case, those health checks did nothing to forewarn me that I would be struck by idiopathic gastroparesis, life-threatening flu, or obstructive lung disease in my middle age.
Krogsbøll et al. recently published a report of their Cochrane review of the effectiveness of general health checks in reducing morbidity and mortality from disease in adults. They found no evidence that general health checks reduced morbidity or mortality, neither overall or for cardiovascular or cancer causes! Not surprisingly, the number of new diagnoses increased with general health checks.
What does this mean for the average person? General health checks may lead to some positive findings and even diagnosis of a condition. However, regardless of what is found by the tests or the subsequent diagnoses and their treatments, undergoing health checks will not change your incidence of illness (morbidity), when you die (mortality), or the disease (if any) from which you die.
But general health checks cost individuals and companies a lot of money (and time), and may lead to unnecessary anxiety and patient harm.
Under the pretense of detecting an asymptomatic disease in its early stage and presumably at a stage in which treatment could be more effective in addressing it, healthcare organizations throughout the world conduct tests and investigations that will inevitably lead to findings that “warrant” further investigation and possibly even treatment. A CEO of a hospital once justified the existence of his hospital’s perennial loss-making “Wellness Centre,” where patients first go for the “health checks,” by viewing it as an avenue for diagnostic and other services to be ordered and then provided by the same hospital, hence generating healthy profits for the organization.
The providers of general health checks often pride themselves in patient education, e.g. with regard to diet, exercise, smoking cessation, etc. I suppose this could help improve the health status of the general population. However, I wonder if the same providers will be equally inclined to reveal that the battery of tests that they ordered had little effect in improving the person’s morbidity or mortality (as traditionally purported) and may even be detrimental to the person because the tests and any subsequent investigation or intervention carry a risk of patient harm with little or non-existent clinical benefit.