I’m a firm believer that, when it comes to drugs and medical procedures, less is more—especially for seniors like me. We take many routine preventative measures in order to improve our health and extend our lives, but are all of these check-ups and tests actually helping us meet our health goals?
An article published by Consumer Reports examined the most popular preventative measure Americans take: annual physicals. In it, researchers and doctors agree that, for most people, annual check-ups are a waste of time and money. Furthermore, the yearly visits often lead to unnecessary and risky follow-up procedures, such as blood tests, EKGs, and chest X-rays.
Instead, the experts emphasize the importance of preventative medical care becoming more personalized. Surprisingly, this advice isn’t coming from patient advocacy groups, as one might expect. Doctors from the American College of Physicians, the American Medical Association and the Society of General Internal Medicine are the ones challenging the long-held practice of yearly physicals. Instead of the annual one-size-fits-all approach, they recommend preventative visits and tests based on one’s age, gender, health and family history.
The Numbers Don’t Lie
Fourteen studies conducted by the independent Cochrane Collaboration that included over 182,000 people showed that annual physicals had no impact on common health indicators. In all of these studies, some participants were given regular annual physicals and others weren’t. Analysis of these studies showed no difference between the two groups in the following categories:
- Number of deaths
- Number of deaths from cancer or heart disease
- Doctor’s visits
- Time off from work
In fact, the Cochrane review indicated that these exams might actually create health problems. Participants who received regular exams had more new diagnoses, including many that might have remained asymptomatic and posed no threat to participants’ longevity. New diagnoses mean that these patients receive additional testing that is not without risks. Tests such as EKGs and blood and urine tests may produce false alarms that then lead to more unnecessary procedures and treatments like X-rays, drug therapies and invasive procedures, which can cause further damage.
Medical Tests: What’s Recommended?
The independent U.S. Preventive Services Task Force offers the following guidelines for healthy individuals. People who exhibit symptoms, have chronic diseases, or have additional risk factors should ask their doctors what other tests and timelines are the best for them. In any case, it’s a good idea to talk with the doctor when weighing the risks and benefits of individual tests.
Blood Pressure Screening
- Who needs it: Everyone ages 18 and over.
- How often: At least every two years. More frequent screenings may be necessary for individuals whose readings indicate high blood pressure (140/80 mmHg for individuals under age 60, 150/90 mmHg for individuals age 60 and over).
Cervical Cancer Testing
- What it is: There are two options for testing. Patients can choose a stand-alone pap smear or a combination pap smear and human papillomavirus (HPV) test.
- Who needs it: Women ages 21 to 65.
- How often: A stand-alone pap smear is recommended every three years for women ages 21 to 65. The combined HPV test with Pap smear is recommended every five years for women ages 30 to 65.
- What it is: A blood test that measures LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides to screen for high cholesterol and risk of developing heart disease.
- Who needs it: All men ages 35 and older and women ages 45 and older with other coronary risk factors, like high blood pressure, current and past tobacco use, obesity and diabetes.
- How often: At least every five years. More frequent screenings are recommended for individuals who have elevated lipid levels.
- What it is: A blood test that measures glucose levels to screen for diabetes.
- Who needs it: Overweight and obese individuals ages 40 to 70. Individuals at an increased risk of diabetes should discuss earlier and more regular testing.
- How often: Every three years for individuals whose blood glucose levels are normal.
- What it is: A breast X-ray to detect breast cancer.
- Who needs it: Women ages 50 to 74. Women in their forties and women ages 75 and older should discuss the benefits and risks of screening with doctor based on their risk factors.
- How often: Every other year.
Colorectal Cancer Screening
- What it is: It could include a colonoscopy (an examination of the entire colon with a flexible scope), a sigmoidoscopy (examination of the lower portion of the colon), or a stool test to detect ulcers, polyps and cancer in the colon.
- Who needs it: Individuals ages 50 to 75. Those at an increased risk of developing colorectal cancer may begin testing earlier than age 50, while individuals over at 75 should weigh the risks of ongoing testing with the benefits.
- How often: Colonoscopies should be done every ten years. In lieu of colonoscopies, sigmoidoscopies should be done every ten years in conjunction with an annual stool test.
Bone Density Test
- What it is: A DEXA scan is a special type of X-ray that measures bone mineral density to detect osteoporosis.
- Who needs it: Women ages 65 and older and younger women whose fracture risk is equal to or greater than that of an average 65-year-old woman.
- How often: Once. Results will determine if a follow-up test is required.
Abdominal Aortic Aneurysm Test
- What it is: An ultrasound to detect potentially deadly ballooning of the main artery that carries blood from heart to the rest of the body.
- Who needs it: Men ages 65 to 75 who have ever smoked.
- How often: Just once.
What About the Dentist?
Twice-a-year dental exams are probably unnecessary, except for people at high risk of gum disease (those who smoke, have diabetes or are genetically prone to inflammatory diseases).
Experts also agree people get too many X-rays in the dentist’s chair. Guidelines suggest that full-mouth X-rays should not recur within ten years. Bitewing X-rays can typically be redone every two to three years for people who have healthy teeth. Talk to the dentist to determine risks and benefits of dental imaging.