Thursday, July 26, 2012

Peace of mind? No, health checks-ups can do more harm than good

When Brian Mulroney, the former Canadian prime minister, went for a check-up in 2005 he was given a CT scan. This discovered two small lumps in his lungs, and surgery was recommended. 

The operation was complicated by inflammation of the pancreas — a serious condition which meant being in intensive care. He spent six weeks in hospital but was readmitted a month later because a cyst, which had developed on his pancreas because of the inflammation, had to be removed as well. 

This was clearly a horrible illness. All those operations, scans, time off work, tests — but wasn’t it worth it if they caught the nodules early and saved Mulroney’s life? Here’s the problem. The nodules weren’t cancer — they were benign. Essentially, Mulroney had surgery and complications for a ‘problem’ that hadn’t actually been a problem.

 ‘Body MOT’ screening tests — like those the politician had — are done for people who are completely well and have no symptoms. You might think, as a GP, I would highly recommend them for reassurance or early diagnosis of problems. 

 Indeed, there are hundreds of posh private clinics that offer ‘check-ups’ with all kinds of blood tests, ultrasound and even MRI and CT scans which are meant to give you ‘peace of mind’ — combinations of tests that cost from £100 up to several thousand pounds. Some tests can be useful, but many are not. Some can end up doing us harm — as happened to Mulroney. How could an innocent check-up be harmful?

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