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What preventive exams really worth doing?

08.20.2015

This article was translated by an automatic translation system, and was therefore not reviewed by people.

 

 

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The number of medical examinations that a person can undergo seems to have multiplied in recent years. The prices of these exams, for those who make the private health system, are high and in the case of those who use the public network, the wait can be long.

In addition, multiply campaigns for everyone to do preventive exams.

But what tests really worth doing?

The doctor and presenter of the BBC, Michael Mosley, decided to undergo himself to a series of these tests to address this question: are we going too far in seeking to be okay?

Cardiac exams

I started with tests to detect heart problems as it is the leading cause of premature death in Britain. The basic tests are free on the NHS (public service of British health) and relatively simple.

First, I did a blood test to measure things like cholesterol. So I went to my medical general practitioner, Sally Jenkins, who measured my height, weight and blood pressure. She put all this data into an online calculator called qrisk and the answer he got was that I have 10% risk of having a heart attack or stroke over the next ten years.

This did not seem great, but it's a little better than average for someone of my age. Anyway, according to Sally, regulations for procedures in this case suggest that I should do a treatment with statins.

I have an ambivalent attitude toward statins. On the one hand they can reduce the risk of death if you have heart disease, but the benefits for those who are apparently healthy are less clear. Asestatinas also have side effects such as increased risk of type 2 diabetes.

Concerns as a result

Not sure what to do, I underwent another test - a cardiac CT scan. At a private clinic in Britain, it can cost between 600 and a thousand pounds (between R$ 3,200 and R$ 5.4000) and also involves a small radiation dose.

After going through this machine, the cardiologist Duncan Dymon examined my exams and began talking about an ominous shadow on one of my main coronary arteries, the left downward. "The reason being is dark due to a soft plaque deposit, rich in cholesterol in the artery wall," said the doctor.

"Is it serious?" I asked anxiously.

"Yes. Do not want to sound too dramatic, but these are dangerous because of the propensity and unpredictability to cause heart attack in someone who is totally fine, no symptoms, he lives a normal life. You go out in the morning to work and not back home "he said.

For this reason, they are known among doctors as "widow's doer".

The doctor could not tell me what were the chances of this episode happens, "if we did, it would be medicine (in the style of science fiction series) Star Trek," but he advised me to take the statin "for the soft plates (treated) statin, metaphorically speaking, have sucked cholesterol out of them. "

I entered the office and cheerful and I left with the words "widow's doer" in my brain.

And this is the problem with some of these particular tests - they can not give more details on the risk of heart problems than a simple examination of the public, and can leave you much more concerned.

Tests for cancer

Cancer is a disease that has the second highest risk of death for people, but the tests to detect the disease generate controversy. Many critics claim that these tests can harm more than help.

One example is the test to detect breast cancer, which is available in the public health system of Great Britain for all women between 50 and 70 years old - and this age limit should increase to 73 in 2016. A report done in the country, called Marmot Report analyzed the evidence of effectiveness of this program and concluded that the examination saved 1400 lives per year.

The Nordic Cochrane Centre in Copenhagen, Denmark, is a respected center of international collaboration between scientists and institutions. And disagrees with the report. The Danish center, because we have better treatments for breast cancer, the defense of mammography was impaired, and recent studies "show little or no reduction in the incidence of advanced cancers with mammography."

Iona Heath, former president of the Royal College of General Practitioners, already critical examination long ago and says he does not choose to do so. "My personal choice is to wait until it detects a lump in her breast and then get the best treatment they have," he said.

Robin Wilson, president of the Advisory Board on Mamas tests in Britain, believes the test saves lives, but recognizes that there are risks. "Women need to know what are these risks and how they are balanced with the benefits to make an informed choice - what we in the profession of medical need to do is improve the discovery of which (case) cancer need not treat" He said.

Prostate

Prostate cancer kills 10,000 men every year in Britain, but the test is even more controversial than mammography. And this is due to the already known inaccuracy of the PSA (prostate specific antigen exam).

As in the case of breast cancer, the problem is you do not sabequal detected tumor will grow aggressively and which will not. If a tumor is detected, there are several options, from surgery to radiation therapy (side effects include incontinence and impotence).

Or simply wait, watching more attentively the patient's health - so-called active surveillance. The doctor waits to see if the tumor is aggressive and rapidly growing or are relatively benign.

"There was a study involving men with all types of prostate cancer and randomly chose one to undergo a radical surgery while others did nothing and, after ten years, there was no real difference in overall survival, "said Vincent Gnanapragasam, who runs a monitoring program in Addenbrokes hospital in Cambridge. "More importantly, men with low-risk cancer showed no evidence of benefit after radical treatment."

Therapy for prostate cancer is not suitable for all cases

On one thing all the experts I consulted agreed: worth doing a test to detect bowel cancer. And the doctors said that even they would undergo this examination. Not the most glamorous exam, but you can save your life.

 

Source: Diary of health

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This article was translated by an automatic translation system, and was therefore not reviewed by people.

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