When it comes to health screening in the 21st century, consumers are often presented with a myriad of packages and choices over the internet. Traditionally, the packages range from basic, mid-range, comprehensive to overtly comprehensive and are categorized by number of tests and hence, price. But has one ever wondered, what exactly are we screening for?
It cannot be overemphasized that people need to know the possible benefits (early detection of clinically significant disease), drawbacks (false positives and false negatives) and outcomes (follow-up tests and treatment) of health screening.
Health screening predominantly consists of two core components, namely laboratory tests which includes blood, urine and stool tests, and imaging which may comprise of chest x-ray, ultrasound, bone densitometry, CT and / or MRI. Ideally, tests should be performed based on the person’s risk factors, age, gender and family history.
|To screen||To prevent or detect early|
|High blood pressure||Stroke and heart issues|
|High cholesterol||Stroke and heart issues|
|High sugar||Diabetes and its end-organ complications|
|Fatty liver||Liver inflammation and hardening|
|Hepatitis||Liver hardening and liver cancer|
|Human papillomavirus (HPV)||Cervical cancer|
|Family history of ovarian cancer||Ovarian cancer|
|Family history of breast cancer||Breast cancer|
|Family history of prostate cancer||Prostate cancer|
|Bone density||Osteoporosis and insufficiency fracture|
Whilst there are a lot of information on benefits on health screening, consumers also need to understand its shortfall, especially when inconsequential disease (pseudo-disease) is detected. When there is pseudo-disease, the risks of yet another set of investigations and treatment may be entailed if results are abnormal. For example, if there is raised prostate specific antigen in the blood test, this could suggest presence of either inflammation of the prostate or prostate cancer. An MRI Prostate may then be requested to exclude prostate cancer and if findings are non-conclusive or equivocal, the patient might go on to have a repeat MRI several months later or be subjected to an invasive procedure to obtain tissue samples from the prostate called a biopsy.
Consumers are therefore urged to understand the gravity of tests and not be confused or blinded with the many choices. Because screening really, is not about a fixed blanket and battery of tests for everyone.
You and your doctor should work together to develop a specific preventive health screening plan for you, execute the plan together and subsequently, review your results with appropriate management and follow-ups, where indicated.