Health Screenings For Chronic Diseases Can Be Risky And 'Waste Resources', Warn MPs
Health Screenings For Chronic Diseases Can Be Risky, Warn MPs
PA / The Huffington Post UK
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NHS screenings aren't the be-all and end-all, according to MPs who have highlighted health risks posed by chronic disease screenings.
According to the Science and Technology committee, checking 'healthy' people for illnesses can sometimes lead to false results and run the risk of the patient being offered treatment, or even major surgery, that they don't necessarily need.
The committee also raised concerns over the health check programme introduced in 2009 which offers patients a 'MOT' from the age of 40, warning it could be a waste of valuable NHS resources.
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Around 11 million patients in England are invited for some form of screening every year, with the bill for breast, cervical and bowel cancer programmes coming in at around £348 million - while a further £400 million is spent on non-cancer testing.
But the committee found that while there are benefits to screening, public perception of the practice is so positive that it is difficult to convey the downsides.
Reforms have recently been made to breast cancer screening information to help patients make an "informed choice" about whether the test is right for them, but the committee was told that the leaflet "still does not fully explain the hazards of false positive diagnosis, ie: mastectomy and radiotherapy being given unnecessarily".
MPs called on the National Screening Committee (UK NSC), the government advisory group, to draw up general screening guidelines to ensure patients are given all the facts.
Committee chairman Andrew Miller said: "Like any medical intervention, screening carries both benefits and risks, whether that is for breast cancer, for aneurysms or hypothyroidism in newborns.
"However, health screening is seen in such a positive light by the public that it can be challenging to convey the negative side of the equation," he added.
"While screening can increase the likelihood of curing, preventing or delaying the progression of disease for some patients, for others it may lead to false results, misdiagnosis and unnecessary treatment.
"More needs to be done to ensure that both the benefits and risks are clearly, and even-handedly, communicated so that people can make an informed choice about whether screening is right for them."
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Health Screenings You Need If You're 50+
1. Checkup & Vaccinations (01 of10)
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How often do you need to get one: Once a year.What you should know: An annual checkup is a must. It is often the key to preventing illness or early detection of health concerns—it also gives you the chance to talk to your doctor about your weight, lifestyle changes, and what to expect over the next five years. Read 7 Ways to Get the Most From Your Doctor to find out what you should be asking at your checkup.While you’re with your doctor make sure you talk about the pros and cons of vaccinations generally considered beneficial to people over 50. The Centers for Disease Control & Prevention recommends the following vaccinations:Flu vaccine – Recommended once a year for anyone over 50. If you are allergic to eggs or have Guillian-Barre Syndrome you should not get the shot.Tetnus vaccine – Everyone should be vaccinated once in their lifetime, then get a tetnus booster shot once every 10 years. If you’re over 65 and have never been vaccinated with the tetnus vaccine, you should get one.Shingles vaccine – Recommended once in a lifetime for people 60 and over. People with weakened immune systems should not get the vaccine.Pneumonia vaccine - Recommended once in a lifetime for people 65+. Also recommended for people under 65 who have compromised immune systems, heart or lung diseases and some other disorders. (credit:Shutterstock)
2. Blood Pressure (02 of10)
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How often do you need it checked: Every two years if it’s normal. At least once a year or more if it’s 120-139/80-89 or higher, according to the National Institute of Health.What you should know: Blood pressure checks are essential because many people who have high blood pressure don't know it. And as you age, it becomes more likely that you can have high blood pressure. High blood pressure can raise your risk of heart disease and stroke. Women who have blood pressure greater than 120/80 mmHg are at increased risk for coronary heart disease, according to the National Heart, Lung & Blood Institute. If you have heart disease, diabetes, kidney problems, or certain other health issues, you'll need to have your blood pressure checked more frequently. (credit:Shutterstock)
3. Cholesterol (03 of10)
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How often do you need it checked: The American Heart Association and the National Cholesterol Education Program recommend anyone over 20 get a baseline measure at least once every five years. However, men over 40 and women over 50 should be tested more often. Many doctors suggest you get tested annually.What you should know: You want to keep in mind three numbers: your total cholesterol number, and your LDL (bad cholesterol) and HDL (good cholesterol) levels. Your cholesterol levels are considered healthy if your total cholesterol is under 200 mg, LDL is under 160 mg and HDL is 60 or above, according to The Mayo Clinic. Cholesterol numbers are also particularly important for people with a family history of heart disease, high blood pressure, or stroke. One more thing to keep in mind: If your doctor suggests testing for cholesterol more frequently, there may be an advantage. Studies show that when patients know they'll be tested more often, they're more likely to stick to a heart-healthy diet (or to take their cholesterol-lowering medication). (credit:Shutterstock)
4. Dental Exam (04 of10)
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How often do you need it: Twice a year. What you should know: Sorry, there's no way around this one. The American Dental Association recommends a check up every six months, not only to get a professional cleaning, but also to detect and prevent tooth decay and gum disease. Also, many doctors now believe that what’s going on inside your mouth is a good indicator of your overall heath. (credit:Shutterstock)
5. Eye Exam (05 of10)
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How often do you need it: According to the American Academy of Ophthalmology everyone should get a baseline exam at age 40, then every 2 to 4 years after that until age 54. At age 55-64, people should get their eyes checked every 1 to 3 years. People 65+ should have their eyes checked every 1 to 2 years.What you should know: Many people put off getting their eyes checked because they see it as less important than, say, a mammogram or a colonoscopy. However, doctors won't just be checking your vision — people over 50 should be checked for cataracts (a clouding of the eye lense), glaucoma (damage to the optic nerve), and macular degeneration (when images begin to appear blurry). (credit:Shutterstock)
6. Mammogram (06 of10)
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How often do you need it: Once a year.What you should know: Mammograms x-ray the breasts and detect early signs of cancer. How frequently women should have mammograms is a source of much debate. Some medical groups including the National Cancer Institute suggest that it is most beneficial (and cost-effective) to have the test once every one to two years, but The American Cancer Society still recommends women get a mammogram once a year starting at age 40. Talk to your doctor about what makes sense for you.Women at higher risk (family history, genetic predisposition) should get an MRI along with their mammogram. In addition to a mammogram, a complete clinical breast exam by a gynecologist or appropriate health-care provider is recommended every year for women older than 40, and every 3 years for patients in their twenties and thirties. (credit:Shutterstock)
7. Pap Test (07 of10)
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How often do you need it: The American College of Obstetricians and Gynecologists recommends that women 30 years to 65 years have a Pap test and HPV screening every five years. Or they can have a Pap Smear every three years. Women over 65 who have had three negative pap tests in a row, or two negative co-tests in a row within the past 10 years, can stop getting pap tests.What you should know: A Pap screening helps test for cervical cancer by finding abnormal or precancerous cells in the cervix. An HPV screening tests for the virus that causes these cancers. One more note: For women going through menopause, the American Cancer Society now recommends that regular checkups include not only a Pap Test, but also information about the risks and symptoms of endometrial cancer—and they strongly encourage women to report any unexpected bleeding or spotting to their doctors. (credit:Shutterstock)
8. Colonoscopy (08 of10)
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How often do you need it: Starting at age 50, every five years or 10 years depending. What you should know: According to the American Cancer Society, both men and women at average risk for developing colorectal cancer should use one of the screening tests below starting at age 50 as a preventative health measure. Talk to your doctor about which test is best for you, but you may need to start screening earlier, if you have a family history of hereditary colorectal cancer syndromes or any other risk factors.You should have one of the following tests:Tests that mainly find cancer and polyps include:•Flexible sigmoidoscopy (have one every 5 years)•Colonoscopy (have one every 10 years)•Double-contrast barium enema (have one every 5 years)•CT colonography which is a virtual colonoscopy (have one every 5 years)Tests that mainly find cancer but not polyps:•Fecal occult blood test (FOBT) (have one every year) • Fecal immunochemical test (FIT) (have one every year)• Stool DNA test (sDNA) (talk to your doctor how often you should have this test.) (credit:Shutterstock)
9. Prostate Exam (09 of10)
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How often do you need it: Baseline reading at 50, then talk to your doctor.What you should know: The prostate is a walnut-sized gland near the bladder that is essential for reproduction. Prostate cancer can affect your urinary and bowel function as well as fertility. There's some controversy about the most-effective frequency of prostate checks. Many physicians suggest getting a baseline check at age 40, while others such as The American Cancer Society, suggest that health-care professionals should discuss the pros and cons of early-detection prostate-cancer testing with men and offer annual testing, starting at age 50. African-American men and those with a family history of prostate cancer should discuss screening at age 45. (credit:Shutterstock)
10. Bone Density Test (10 of10)
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How often do you need it: Women older than 65 and men older than 70 should have a baseline bone density test (DEXA scan).What you should know: A bone density test tells how much calcium and minerals are in your bones, and can detect whether or not you are at risk for osteoporosis (a condition where the bones become brittle and fragile.) As with some other tests, there has been some controversy in recent years as to how often you need a bone density test. Until recently, women over 65 and men over 70 were advised to get a bone density test every two years. But this year the U.S. Preventative Task Force released a study that if you are a woman and your baseline test is normal you can go up to 15 years until your next test. The study found that the benefits of screenings for men were men inconclusive. Once you get your baseline, talk to you doctor about how often you need a follow-up. (credit:Shutterstock)
The NHS Health Check programme - which is aimed at preventing heart disease, stroke, diabetes and kidney disease - was introduced five years ago without rigorous evidence and was not reviewed by the UK NSC because it is not classed as a screening programme, the committee found.
But the lack of scrutiny by the NSC gives rise to "serious questions" about quality of the evidence over whether it can achieve its aims, leaving MPs concerned it could be "wasting resources".
Mr Miller added: "Developments in genetic science mean that it should soon become possible to target screening programmes directly at those most of risk of certain diseases.
"It is imperative that the UK National Screening Committee develops its capacity for horizon scanning and ensures that proven developments in screening are supported and implemented across the NHS."