Why you should ignore modern craze of disease screening if healthy

Not too long ago, a close friend asked to see me over a medical matter. Since my speciality is at odds with any potential health matters the said friend may have been experiencing, I instinctively tried to dissuade him from seeking my views. He’d have none of it and eventually ended up in my office.

Turns out that something unusual had been noticed during a habitual annual medical evaluation. There were no accompanying symptoms. The attending doctor was quick to recommend a surgical procedure, which got my friend pretty confused.

Should he undergo a surgical procedure for something incidental, and appear to be innocent? And could progression to a symptomatic phase be predicted? If he did nothing, would this ‘thing’ eventually kill him?

Medical screening, in the absence of symptoms, is a common practice. The aim is to unearth those at risk of developing some sort of disease that can be cured, or controlled if detected early enough. However, there are principles that must be upheld when screening people for any disease. One of the key points is only to screen people if the eventual benefits outweigh any harm. In other words, there must be scientific validity of screening linked to subsequent beneficial medical interventions.

An example is the screening of women for cervical cancer, which continues to reduce related deaths. But then there’s medical hype about health screening, partly driven by the healthcare business. You will find unfounded advice for all sorts of medical screening, and consequent questionable interventions if something comes up.

If randomly selected healthy people get misguided medical testing, incidental findings will always show up, even when such findings are harmless. There’s actually a medical term for it, ‘incidentalomas’, in other words just incidental findings. What my friend had was an incidentaloma. Should he act on it? Well, he couldn’t just ignore it now that it was preying on him. I advised him to see a specialist colleague who deals with the specific organ involved. Inevitably, there was going to be more testing, more dilemmas, and eventually a decision on what to do.

If you are healthy, you hardly need any testing for hypothetical medical conditions. Adhere to current advice for disease screening that is appropriate to your specific circumstances. That means age, family history, disease exposure and other risk factors.

Leave out new-age fads about disease screening that are mostly driven by hype and profit. You are unlikely to benefit. You’ll certainly spend a tidy sum, end up with anxieties, and possibly get harmed in the process.