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Experts warn yearly checkups carry risks and do not reduce mortality

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Re: Experts warn yearly checkups carry risks and do not reduce mortality

#22

I find this to be dubious and honestly a little insulting. Here in the UK there is a not insignificant number of people that die from cancers because their local health practice ignored or even refused to listen to a patient. The idea of a yearly checkup is totally foreign here unless you are going private.

There's no contradiction. Ignoring symptoms is foolish. Yearly checkups may do more harm than good. Both of these things can be true.

A lot of cancers have no symptoms at the beginning, but they can be flagged in blood tests performed as part of general health checkups.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#24
post #13
post #8

Earlier quoted context omitted.

Interestingly, the scenario is somewhat discussed in the article: "...Rivero used as an example a request he receives frequently: to check the cholesterol of young people with no risk factors. “Checking a 32-year-old man with no history of sudden death or hypercholesterolemia in the family is pointless,” and can result in prescriptions for medication of questionable usefulness and that is not without risk in the even…

I get the logic, but … isn’t this failure mode the fault of the doctor, for overreacting to a minor issue/non-issue, rather than the patient for getting yearly checkups?

It may be a failure of the doctor, but we want to measure mortality in our world, not a magical one where doctors are perfect.

The takeaway here can and should be that interventions are started too soon, but that's a more difficult change than for healthy people to just reduce testing.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#27
post #5

That’s BS if I may. How would I know I have higher cholesterol if I didn’t do blood tests?

As others are pointing out, cholesterol is a lab indicator not a symptom or disease out right. Cholesterol numbers are a proxy for risk for a negative event, but only a weak proxy. If you're otherwise healthy and don't have a family history of cardiac events then your cholesterol numbers probably don't matter. Trying to control those numbers in the absence of other risk factors presents other risks. Cholesterol medicines aren't without side effects, so you're best off not taking them if you don't need them.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#28
post #13
post #8

Earlier quoted context omitted.

Interestingly, the scenario is somewhat discussed in the article: "...Rivero used as an example a request he receives frequently: to check the cholesterol of young people with no risk factors. “Checking a 32-year-old man with no history of sudden death or hypercholesterolemia in the family is pointless,” and can result in prescriptions for medication of questionable usefulness and that is not without risk in the even…

I get the logic, but … isn’t this failure mode the fault of the doctor, for overreacting to a minor issue/non-issue, rather than the patient for getting yearly checkups?

[dead]

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#29

I find this to be dubious and honestly a little insulting. Here in the UK there is a not insignificant number of people that die from cancers because their local health practice ignored or even refused to listen to a patient. The idea of a yearly checkup is totally foreign here unless you are going private.

I think the idea is this: even accurate tests have false positives. For patients in a low-risk group, virtually all positive results in the checkup will be false positives. When the low-risk group is large (the entirety of a nation's healthy 20-30 year olds), the number of such false positives will also be large.

The positive results, regardless of whether they are true or false, will have some sort of follow-up. Maybe a second, more invasive test, maybe even starting on a drug straight away if the numbers look bad. And like for any medical procedure, there is a chance that this follow-up will harm this person's health: they will get an infection from a badly done second test, they will have an adverse reaction to the drug, etc.

And the question is whether it is ethical or worthwhile to expose patients to the risk of harming their health through the follow up, given that the chances of them having the condition (and thus of the follow-up being at all useful) are extremely low regardless of what the checkup result says.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#30
post #13
post #8

Earlier quoted context omitted.

Interestingly, the scenario is somewhat discussed in the article: "...Rivero used as an example a request he receives frequently: to check the cholesterol of young people with no risk factors. “Checking a 32-year-old man with no history of sudden death or hypercholesterolemia in the family is pointless,” and can result in prescriptions for medication of questionable usefulness and that is not without risk in the even…

I get the logic, but … isn’t this failure mode the fault of the doctor, for overreacting to a minor issue/non-issue, rather than the patient for getting yearly checkups?

Doctors are generally instructed to aim for optimal outcomes.

Suppose 98% of people taking a drug as prescribed live longer, but 2% don’t use as described and they offset the gains. Should the drug be prescribed or not?

Similarly, what if people who do annual checkups and get good numbers take worse care of themselves because their numbers are healthy?

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