Health checks without benefit?

Chochrane study shows no positive effect of general health checks

10/18/2012

General health checks at the doctor today are a widely used method to detect possible diseases early and counteract accordingly therapeutically. However, a recent study by researchers at the Cochrane Collaboration concludes that the health checks have no impact on patient morbidity and mortality.

Although patients with health checks have been diagnosed with significantly higher prevalence of diseases such as hypertension or hypercholesterolemia, the „General health checks do not reduce morbidity or mortality, neither overall nor for specific cardiovascular or cancer diseases“, The researchers report to Lasse T Krogsbøll from the Nordic Cochrane Center online in „The Chochrane Libary“. Thus, the health checks for the patients may be of no use.

Health of 180,000 patients checked
As part of their study, scientists from the Nordic Chochrane Center in Copenhagen (Denmark) reviewed 14 previous studies that compared patients with regular health checks and a control group without appropriate medical screening. The studies considered were from 1963 to 1999 and included a total of 182,880 participants. Nine studies explicitly investigated possible relationships with the risk of death (155,899 participants, 11,940 deaths). According to the researchers, there was no effect of health checks on overall mortality and risk of death from cardiovascular disease or cancer.

Increased number of new diagnoses through health checks
However, patients were actually diagnosed with more diseases in the health checks. Thus noted one of the evaluated studies „a growing number of people with high blood pressure and high cholesterol“ firmly, report Lasse Krogsbøll and colleagues. In addition, the study has identified an increased number of chronic diseases in patients with health checks. Also, one of the earlier studies found that the total number of new diagnoses per participant in the six-year health check group increased by 20 percent compared to the control group. The increased detection of the diseases, however, had no effect on mortality.

Health checks with no effect on mortality
According to the Danish researchers, overall mortality during follow-up was 75 out of 1,000 in the control group and 74 out of 1,000 among the participants with health checks. For the separately considered deaths due to cardiovascular diseases and cancer, a comparably small difference between the control group and the intervention group was observed. Here, 37 out of 1,000 subjects in the control group and 38 out of 1,000 subjects died with health checks. In cancer mortality, the values ​​of both groups even agreed (21 out of 1,000). An effect of health checks on the mortality rate could therefore not be determined.

Do not extend health checks
The incidence of diseases, such as coronary heart disease, non-fatal heart attacks and strokes, as well as chronic diseases, also did not benefit from the health checks. „One reason for the apparent low impact of health checks may be that GPs already recognize and intervene in health problems without them, if they are caring for a patient at high risk for the disease“, write the researchers of the Nordic Chochrane Center. Therefore, the study results should not be misunderstood as a call to discontinue health checks. In case of clinical suspicion these are appropriate in every case. However, the Danish researchers see no sense in the systematic introduction of general health checks for the entire population. (Fp)

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Benjamin Thorn