Jun 29 2005
Though you and your doctor might think that yearly checkup is just a routine part of staying healthy, that practice isn't endorsed by a panel of experts.
They are saying there is no evidence to suggest that annual physicals for healthy people are useful.
In a recently published survey, 65 percent of primary care doctors said such checkups are necessary and nearly 9 out of 10 said they carry out the examinations.
The survey, conducted in 2002 by Dr. Allan Prochazka and colleagues at the University of Colorado Health Sciences Center, re-ignites a debate over annual physicals that goes back almost a decade.
At that time the U.S. Preventive Services Task Force declared there was insufficient evidence of any benefit from many of the tests often given with yearly checkups.
The task force, which is a respected non-governmental panel of researchers, commissioned by Congress to develop evidence-based recommendations for medical care, does not recommend for or against annual physicals, and neither does the American Medical Association.
However many among the 783 doctors queried in the survey said that routine exams should include tests that the task force says haven't been proven to prevent disease in healthy adults, including urine tests, blood-sugar tests for diabetes, and thyroid tests.
The researchers said that the most frequently recommended tests included complete blood counts, which check for conditions including anemia, and almost 40 percent of doctors said those tests should be part of routine physicals, despite studies showing "that there is very little yield" from routine CBC testing.
But Dr. Ned Calonge, the Preventive Services Task Force chairman, said he is concerned by the fact that so many people were ordering tests of unknown benefit and even potential harm if they lead to unnecessary invasive follow-up testing.
According to the study, routine physicals have been popular since the early 1920s, when an article in the Journal of the American Medical Association discussed their value in finding disease in apparently healthy people.
Today technology and the development of screening exams, such as Pap tests for cervical cancer, mammograms and colon cancer tests, have reinforced the idea that yearly exams are needed, and many medical groups recommend that these tests be done routinely, though not necessarily every year.
In general pap tests are recommended at least every three years for women of childbearing age, or every year if a recent test had abnormal results, colon cancer screening, at intervals up to 10 years apart, and mammograms at least every two years which are not recommended until middle age.
Dr. Arvind Goyal, a preventive medicine specialist, called the task force "a moving target" whose broad recommendations often don't apply to individual patients.
Goyal gave a good example in saying he would recommend an annual physical and exercise stress test for a 45-year-old man whose father died young of a heart attack, but not for all 45-year-olds.
He maintains that yearly physicals still have value even for healthy patients with no risk factors, as they create an opportunity to get to know patients and ensure their lifestyle habits will keep them healthy.
Many health insurers already pay for some periodic preventive screening but not annual physicals.
In an earlier study by the same researchers they found that about two-thirds of consumers believe an annual physical is necessary, but only one-third would want one if they had to pay for it.
The report is published in the Archives of Internal Medicine.
Study shows cannabis as a genotoxic substance with cancer risks