Good Health Blog

Testing times

- June 6, 2013

When you go to the Doctor for a check-up do they go through your health habits, family history and past medical history to determine what the ‘check-up’ should entail?

We all know that prevention is a vital part of your health care. Medical tests are an important part of preventative activities but you need to be aware that not all tests are infallible as some have high false-positive or false-negative rates. Some tests do not have sufficient evidence of producing a benefit in apparently healthy people and some tests have good evidence of harm from over-diagnosis.

It is very important that any tests performed are supported by guidelines for which there is a strong evidence base. When tests are ordered for you ensure you are part of the decision making process so that they are appropriate.

So, why should a health website be telling you this? The simple reason is when patients come to see me for a ‘check-up’ quite often I have to educate and sometimes talk them out of having some tests. There are two very popular test ‘requests’ that I receive. They are the prostate and the bowel cancer screening tests. To explain the difference in how these tests work I will compare and contrast them.

Both bowel and prostate cancer are significant health problems. The natural history of bowel cancer is well understood but with prostate cancer there pattern can be very slow through to aggressive.
Bowel cancer has a clearly recognizable early stage but the early stage for prostate cancer is not well understood. Early treatment for both cancers are available and beneficial but for Prostate cancer there is no suitable test to distinguish between the types. The commonly requested PSA (Prostate Specific Antigen) test is non-specific and a positive result can indicate numerous conditions. Current evidence suggests that the potential harm outweighs the benefit of the PSA test as a population screening tool in healthy individuals.

In contrast to the PSA test, the FOBT (Faecal Occult Blood Test) shows a definite benefit for early identification and removal of potentially cancerous grows in the colon in people with no symptoms.

Ensure your Doctor takes the time to determine what is right for you when it comes to a ‘Check-up’. Be informed. Doing an health screen will put the science and guidelines into action for your benefit.