Medical Tests: How Good For You Are They?

by Research Insights0 comments

Share this page:

At boomer age, our doctors seem almost too keen to prescribe some test or another. Are they being cautious, checking ’just in case’ – or are there some tests we’re better off without?  

What The Heretics Say

Medical Tests How Good For You Are They Mendelsohn
Cover of Mendelsohn’s 1979 heresy

If you’re feeling fine, avoid regular check-ups,’ advised Robert Mendelsohn back in 1979, in his book Confessions of a Medical Heretic. He argued that going for a check-up was akin to challenging the medical system to find something wrong with you. It usually does, he concluded.

About 40 years later, English TV doctor, Michael Mosley reached a similar conclusion. He submitted himself to a battery of screening tests and exploratory procedures to find out which were worthwhile for him. These included a CT scan (for heart), PSA test (for prostate cancer) and a bowel scope (for bowel cancer).

He concluded that ‘…having my blood pressure tested and my bowels screened were a really good idea, but many of the other tests I did were more likely to induce anxiety than to find out anything worthwhile.’

The last comment was made about PSA (prostate specific antigen) tests which, if positive or inconclusive, can lead to ‘unnecessary biopsies and aggressive treatments’ which are uncomfortable in more ways than one.

having my blood pressure tested and my bowels screened were a really good idea, but many of the other tests I did were more likely to induce anxiety than to find out anything worthwhile.’

Dr Michael Mosley, English TV Doctor

Mosley was more enthusiastic about multi-parametric magnetic resonance imaging(mpMRI), a new type of MRI scan that can distinguish rapidly-growing cancers from more benign forms, and has fewer downsides. Get all the detail here in this summary of Mosley’s BBC documentary.

Not Just Heretics

Medical tests how good for you are they Mosley
English TV doctor, Michael Mosley, another heretic

In 2020, the BMJ published a systematic review titled ‘Overuse of Diagnostic Testing in Healthcare. Its conclusion? ‘Overuse of diagnostic testing substantially contributes to healthcare expenses and potentially exposes patients to unnecessary harm’. The range of over-testing ranged from near zero to 97.5%, with most being for lower back pain. (This was too close to home for me. See more below.)

A University of Sydney Study in 2020 came to much the same conclusion:

Medical tests provide important information to guide clinical management. Over-testing, however, may cause harm to patients and the healthcare system, through misdiagnosis, false positives, false negatives and over-diagnosis.’

In Australia, Medicare paid for 27 million diagnostic imaging tests in 2017-18. That’s a staggering number of tests, especially if not all of them are necessary. Also, except for Ultrasound and MRI, all use high-energy, ionising radiation which can damage DNA and cause cancer.

Prevalence estimates of diagnostic testing overuse ranged from 0.09% to 97.5%

BMJ Quality & Safety Review 2020

What About Safety?

Don’t worry, it’s about the same radiation as you’d get on a return flight to Melbourne.’

That’s what my GP said when I queried the need for a CT scan (Computed Tomography or multiple X-ray technology) on my lower back. He said the pain in my hip was most likely caused by a pinched nerve in the spine.

As it turned out, it wasn’t. I didn’t know that at the time, but I did want to know more about CT technology.

I discovered that a lumbar spine CT scan would hit me with between five and 10 millisieverts (mSv) of radiation. That’s the equivalent of 200 chest X-rays or 25 mammograms of both breasts, if you’re a woman. Using the CDC’s calculation, I’d have to take between 150 and 300 return trips to Melbourne to get that dose. Harvard Health and Choice has a few more details on this, if you’d care to dig.

Don’t worry, it’s about the same radiation as you’d get on a return flight to Melbourne.’

So said my GP. I found it was between 150 and 300 return trips.

Why would I expose myself to that much radiation unless my life depended on it? It was hip pain – but at times so painful I’d scream – so I chose MRI. It wasn’t covered by Medicare then, as the CT scan was, but it didn’t use any ionising radiation, either.

Not The Only One

medical tests how good for you ct scanner
What a CT scanner looks like

It’s not just me who’s worried about CT scan radiation.

Berrington de González et al in the National Library of Medicine, estimated in 2009 that at least 2% of all future cancers in the US—almost 30,000 cases and 15,000 deaths per year—would stem from CT scans alone. More recent estimates are likely higher since our exposure to diagnostic x-ray imaging has grown by 600% in the last 3 decades.

In Australia, 128,000 angiograms (CT scans of the heart) are carried out every year, each with a radiation dose of 15 millisieverts (mSv); that’s 50% more than the recommended annual radiation exposure, according to ARPANSA.

In the USA a million angiograms are performed a year. A data linkage study of 11 million people run by the University of Melbourne showed that ‘a single CT scan increased the risk of cancer by 24%, and the risk increased another 15% for each subsequent scan’.

‘…a single CT scan increased the risk of cancer by 24%, and the risk increased another 15% for each subsequent scan’.

University of Melbourne study of 11 million people

Yet CT scans are being prescribed almost as freely as pain killers. Australia has more CT scanners than any country (other than Japan):  70 per one million people. Could there be a link with our world-beating rates of cancer?

Footnote: The pain in my hip was an inflamed bursar, diagnosed by an osteopath after 18 months of pain and six professional opinions that were way off the mark. The excruciating pain was eliminated in three months by avoiding some exercises (I must admit, some were a bit unwise) and adding some gentle ones, instead.

Of course, some tests can be vital but, clearly, not all fit this category.

For more on the risks and benefits of common cancer tests, and the causes of cancer and what you can do to avoid it, check out my eBook Cancer: Make Your Own Luck.

Cancer: Make Your Own Luck

CANCER: MAKE
YOUR OWN LUCK

Discover how Aussie boomers can take control & cut the risk

Kim Brebach

Kim Brebach

Hi, I’m Kim Brebach, boomer, information researcher, technical writer and Joiner of Dots at M&M. In my spare time, I review wines and love to cook.

[]
×
Like an EXTRA 5% OFF?

Claim your discount now

No thanks. I'm happy to pay the offered price. *You can unsubscribe at any time.