Common sense and "conventional wisdom" tell us that getting a medical examination every year, especially after a certain age, is a good idea. After all, the routine checkups can help our doctors to detect the early signs of diseases and, if they are present, begin treatments that can potentially save our lives, right? But science is often about challenging "conventional wisdom" to see if it's really true. That is what a number of researchers from Denmark did in their survey of 14 long-term trials (lasting an average of nine years each) that involved 182,880 subjects. Many of the subjects in the study had regular general health checkups, and many did not.
Interestingly, nine of the trials found no difference in the number of deaths that occurred during the periods covered by the trials. This included deaths from cancer and heart disease, two disorders that are most often looked for during such checkups.
Furthermore, in the review conducted by the Nordic Cochrane Center of Copenhagen, the researchers found no difference in the number of disabilities, hospital admissions, specialist referrals, additional visits to doctors, and time lost from work as a result of illness. One of the trials did find a 20% increase in diagnoses of disease found in those who got frequent health checkups, and other trials noted an increase in the total number of patients prescribed drugs to control high blood pressure, but neither of these findings translated into significantly improved health outcomes.
So how effective is preventative care screening?
This review brings into focus an already controversial issue for health care providers and consumers – how valuable are these yearly checkups we've been told to get? Study lead Lasse Krogsbøll answers this question in accordance with the data found in his review: "From the evidence we've seen, inviting patients to general health checks is unlikely to be beneficial." Krogsbøll said further that ideally "…screening should be based on evidence from randomized trials showing a favorable balance between benefits and harms. In our review we could not find that, and we therefore cannot see any justification for public health programs pushing for routine health checks."
His findings are echoed by similar evidence presented by the United States Preventive Services Task Force (USPSTF), which indicates that the hard medical facts do not always support the idea that screening leads to better health. This seems to be especially true when screening for conditions such as prostate and breast cancer. "Early detection" of the indicators for these conditions using PSA testing and mammograms has often resulted in treatment of tumors that were not likely to cause serious disease, treatments that often wound up causing a great deal of emotional and physical stress. As a result, the USPSTF has now rescinded its previous guidelines, and now recommends that women don't need to get yearly mammograms until after the age of 50 (their previous recommendation was 40), and that most men don't need the PSA test for prostate cancer at all.
Are yearly checkups the best use of our medical resources?
This challenge to "conventional wisdom" has left both doctors and patients in the exasperating position of trying to figure out – when it comes to preventative checkups – how much is "enough" and how much is "too much." In an editorial presented along with the Danish study, two Canadian doctors argue that yearly preventative health checkups may be a waste of health care resources. They point out that "…patients who seek or are willing to undergo routine screening are generally healthier than those who are not … indicating that general health checks are least likely to reach those who could benefit the most [from them]."
All authors and reviewers in these studies agree, however, that the jury is still out on this question, and more research is needed, both to justify the benefits of yearly health checkups, and to improve the methods used in those checkups to detect and prevent diseases. So the question posed in the title of this article remains unanswered, and until it is, your best approach as a savvy health care consumer might be to get as many opinions as you can from doctors and medical experts as to how often you really need a medical checkup, and then use your best judgment.