Enough With the Annual Check-Ups?

Photograph: Altrendo/Getty Images

“FOR decades, scientific research has shown that annual physical exams — and many of the screening tests that routinely accompany them — are in many ways pointless or (worse) dangerous, because they can lead to unneeded procedures.”

Thus spake Elizabeth Rosenthal of the New York Times earlier this year. With all the talk of prevention being cheaper than treatment, we need to take a serious look at what constitutes rational preventive care.

Personally, I have no idea what to do about PSA tests. The U.S. Preventive Services Task Force, a nongovernmental panel of independent experts in prevention and evidence-based medicine, says that we shouldn’t run these tests routinely. My doctor thinks otherwise. How many peer-reviewed papers do I have to read to make the right decision?

Answer: There is no right answer. The doctor makes his conclusions based on clinical experience and scientific evidence. The Task Force looks at large populations of men. Can I live with the odds? What if I’m am outlier? Should the insurance company (meaning all of us, now) have to pay for a test?

The Big Questions: Will prevention result in improved wellbeing, and Is our push for prevention going to lead to higher costs or lower?

Something to wonder as you sit in the exam, freezing in nothing but that  hospital gown, waiting for the EKG patches to get glued to your chest, or the annual Pap smear, or the ol’ prostatic palpation.

(from the New Yorker Rejection Collection)

Current guidelines recommend that women should have a Pap test every 3 years beginning at age 21. These guidelines further recommend that women ages 30 to 65 should have HPV and Pap cotesting every 5 years or a Pap test alone every 3 years. Women with certain risk factors may need to have more frequent screening or to continue screening beyond age 65.

–From the National Cancer Institute Website