Hyderabad: Is a general health check-up really required for all? Has it really worked in preventing cardiovascular diseases and diabetes for which the maximum screening is carried out?
No. The reason is because the screening method is only to identify a disease and not to prevent it.
The general health check-up looks into the lipid profiles, blood glucose, functioning of the heart, abdomen and chest scan and gives an indication of what the levels in the blood actually are.
Hidden diseases like cancers, infections, problems in the spine and other nerve conditions emerge only when there are symptoms.
Dr K.R. Reddy, senior general physician, said general health check-ups are not recommended for all. “These are being commercially exploited. People are made to pay every year for a disease which they may eventually get. The prevention of a disease is the biggest thrust that must be stressed upon but is missing,” Dr Reddy said.
He said that there was no proper national programme for prevention. “Lifestyle and diet changes have affected all sections and that is increasing the burden of diseases,” he said.
Dr Navoday Gilla, consultant physician, explained, “Earlier people ate limited quantities of food and worked hard. Now, people are eating and sitting which is only adding to their weight. Energy expenditure is completely missing. Due to this reason there is early advent of diseases.”
For these diseases, she said risk factors like family history of diabetes and cancers makes the family group vulnerable and they must regularly opt for health check-up for their glucose levels and risk of cancer. “The otherwise healthy population, which is not in the vulnerable group and is leading a healthy and active lifestyle, do not require regular check-ups,” Dr Gilla said.
The present set-up of screening and intervention is largely based on identifying the disease early. The identification is then followed by lifestyle changes when there is a borderline case or medication to prevent further damage.
Dr Narsinga Reddy, national member of the Indian Medical Council in Telangana, explained, “The methodology that is presently in place stresses on screening and preventing further damage to the body. This is being done as lifestyle and diet are leading to early advent of hypertension, high triglycerides, glucose and metabolic disorders.”
He said that earlier, the general health check-up was recommended for those above 40 years of age. But now the bar had come further down to 35 years of age due to the changed lifestyle.”
A study published in the Internal Medicine Archives found that general health check-ups in a 10-year follow up have shown that it has not helped to prevent mortality or even reduce the burden of cardiovascular and diabetes.
The study states that there are multiple tests which are done in otherwise healthy individuals who have no symptoms and hence it becomes only a reassurance or a purpose for finding a disease. In the case of the latter, it makes the person susceptible to unnecessary treatment which may not be required.
Multiple trials in control groups have been carried out and it was found that a better way to identify a disease was when the family physician or general physician suspected that the person was at a high risk to develop a disease.
The study noted that since the primary care physicians were told about the symptoms, they were better equipped to suggest the screening process. It was found that in the controlled group where there were no general health check-ups, it was only on the advice of the general physician that they opted for the screening process.
Hence only those at high risk for a disease were screened and accordingly, lifestyle changes implemented.
Lifestyle counselling in the real sense is a tough task as it is not one size fits all and can differ from person to person. Those whose metabolic rates are lower and body stores food would require different changes as compared to those who are hyper all the time.
Similarly, lean obese individuals need to be tackled differently from overtly obese. Hence lifestyle counselling can’t be generalized but can be made convenient by being based on body types.
