October 17, 2012
Researchers Say General Health Checkups Do Not Save Lives
Lawrence LeBlond for redOrbit.com - Your Universe Online
Most people visit their doctors for regularly-scheduled general checkups with the notion that doing so provides them with the security of knowing they will live a long, happy life. But those people could be accepting false hope, according to Danish researchers who carried out a recent study.
The researchers found that patients who had general health checkups died of cardiovascular disease and cancer at virtually the same rate as those who forewent check-ups. The researchers noted that, not only do their findings show general healthcare checkups do not offer any added security, but may also cause undue stress, which may or may not play a part in the findings.
Analysis of 16 clinical trials involving 183,000 patients yielded mortality risks of 1.01 and 1.03 for people who had general checkups versus those who did not, according to Lasse T. Krogsboll, of the Cochrane Nordic Center in Copenhagen, and colleagues.
Based on their findings, the researchers, who carried out the review for The Cochrane Library, are warning against offering general health checkups as part of a public health program.
In England, people between the ages 40 and 74 are offered free health checkups. The initiative was started in 2009 and was designed to spot conditions such as heart disease, stroke and diabetes by looking for silent risk factors such as high blood pressure and cholesterol. Ministers said they believed such measures would save at least 650 lives every year.
But the latest findings suggest these routine checkups are a waste of time.
These general health checks, intended to reduce deaths and ill health by enabling early detection and treatment of disease, could be leading to potentially negative implications, for example diagnosis and treatment of conditions that might have never led to symptoms or shortened life.
While a few of the trials analyzed in the study showed an increase in diagnoses after general health checks, the researchers noted many of the trials were poorly studied. In one of the trials, it was also noted that most patients who were offered free general health checks, were already more likely to be diagnosed with high blood pressure or high cholesterol. In three other trials, large numbers of abnormalities were identified in the screened groups.
However, based on nine of the trials with a total of 11,940 deaths, the researchers found no difference between the number of deaths in the two groups in the long term, either overall or specifically due to cancer or heart disease. While other outcomes were poorly studied, the researchers suggested, based on the evidence garnered, offering general health checks had no impact on hospital admissions, disability, worry, referrals, additional checkups or time off work.
“From the evidence we've seen, inviting patients to general health checks is unlikely to be beneficial,” said Krogsboll. “One reason for this might be that doctors identify additional problems and take action when they see patients for other reasons.”
“What we're not saying is that doctors should stop carrying out tests or offering treatment when they suspect there may be a problem. But we do think that public healthcare initiatives that are systematically offering general health checks should be resisted.”
He said any screening program should be able to prove the benefits outweigh any potential harm, something he said has not been proven in these trials.
But, not everyone agrees. And a number of health experts still believe general health checkups save lives.
“By spotting people who are at risk of heart attacks, diabetes, stroke and kidney disease we can help prevent them,” a Department of Health representative told BBC News. “The NHS Health Check program is based on expert guidance. Everyone having a health check is offered tailored advice and support to manage or reduce their risk of developing serious health conditions.”
The researchers said despite their findings, more studies are needed and should focus on the individual components of health checks and better targeting of conditions such as kidney disease and diabetes. They should be designed to further explore the harmful effects of general health checks, which are often ignored, producing misleading conclusions about the balance of benefits and harm.
Another problem is that those people who attend health checks when invited may be different to those who do not. People who are at a high risk of serious illness may be less likely to attend. Also, most of the trials in the study were old, “which makes the results less applicable to today's settings because the treatments used for conditions and risk factors have changed,” concluded Krogsboll.
The researchers reported their findings online in the Cochrane Database of Systematic Reviews.