May 10, 2013

Health Screening, Assessments or Checks: Whatever the label, they help save lives


Health screening has been around for several decades as a way of investigating everything from a woman's fertility to her blood cholesterol levels, and along the way it has gathered critics as well as advocates. Critics of private screening point out the potential for 'false positive' test results - that is, being told there is something wrong when in fact there is not - which can place extra pressure on an already-strained NHS, and can cause unnecessary worry in patients. Others argue that some patients given the 'all-clear' can become complacent about their lifestyle, rather than making healthy, positive changes. On this latter point, is this really an issue? Health checks are overwhelmingly an opportunity for the individual to take more control of his or her health.

Most people opting for health screening will learn something which they were previously unaware of, or were simply ignoring, such as their weight, blood pressure or cholesterol levels.

Clearly the NHS has a role in keeping us well, as well as treating us when we are unwell. Indeed, Public Health England announced last week that one of its priorities is to "support people to live healthier lives" and is rolling out NHS Health Checks to reach 15 million eligible people in England over the next three years. So really, the 'public versus private' issue is academic. The fact remains that screening can and does educate us about our health, and open up choices. Moreover, it can and does save lives.

We read about a particularly compelling case for screening in Andrea Kon's article in this week's Good Health (The Daily Mail) and in turn, we were compelled to write. The article focuses on a patient case study involving a 60 year old man from Cambridge who underwent a full MOT health check four years ago, after which, over a period of three years, subsequent private screening revealed his PSA count (a potential indicator of prostate cancer) steadily rising. He was therefore referred to a consultant urologist, after which he became one of the first Britons to undergo a new, more accurate type of prostate biopsy.

The new technique involves the use of two diagnostic tools, instead of just one: Ultrasound images are superimposed on to MRI images, giving a 3-Dimensional view. The surgeon is therefore better able to target tissues where the cancer could be, and uses needles guided through the perineum rather than the usual route which involves piercing the bowel. (For the patient, this latter factor means less pain and lower infection risk, post procedure.) The patient in question turned out to have an aggressive form of prostate cancer, so the organ was removed, and he is now free from the disease. In his words, "I dread to think of where I'd be if it hadn't been for that new approach. I believe it saved my life."

Besides being impressed by the technology aspect of this story, we could not help but wonder what would have happened to this man, had he not opted for the initial health screening. Despite the fact PSA tests provide an indication rather than a diagnosis of prostate cancer, further analysis via this new biopsy technique probably saved this man's life: A case of simply removing more than just 'doubt'.