I'm always happy to take a few minutes to focus on the topic of preventive health screening tests. I think they are so important to maintaining your health over your lifetime. But it's also important to understand the limitations of screenings and preventive efforts and to know that even if you saw your health care professional for a checkup every month, something could still go wrong.

Unfortunately, I think too many people put too much faith into testing, not realizing that many tests may be unnecessary, not to mention expensive. For instance, in a Consumer Reports survey of 300 primary care physicians, 34 percent said their patients "very frequently" or "quite often" requested unnecessary or duplicative medical tests. The doctors aren't blameless; about 60 percent said they quite often ordered unneeded tests to protect themselves against malpractice suits.³⁴

So here are a few things you can do without. Start with that annual checkup. You don't need it! Every two to three years is probably enough if you're in general good health and aren't experiencing any symptoms. For example, women over 30 who have a normal Pap test don't need another for two or three years; those over 30 with a normal Pap and HPV test don't need either for three years. And if you've had a hysterectomy and had your cervix removed for reasons other than cancer, you don't need a Pap at all. Yet, I see older women all the time who had their cervix removed as part of a hysterectomy years ago and still turn up at their gynecologist's every year for a Pap.

Another unnecessary test is a whole-body screen. You've probably seen these CT screenings advertised in your local newspaper or on TV. They cost $1,000 or more and are marketed as an early warning system for spotting cancer, heart disease and other health conditions. But the U.S. Food and Drug Administration notes that they have no proven benefits for healthy people and expose people to excess radiation, enough, in some situations, to actually increase your risk of cancer. Plus, the American College of Radiology, the American College of Cardiology, and the American Heart Association do not recommend whole body CT screening for healthy people with no symptoms.³⁵

Another test I fear is overdone is the spiral CT to diagnose lung cancer. While studies find that the test can identify cancers early, there is no evidence that this actually makes a difference in terms of outcomes, or deaths from lung cancer. Plus, the scans are expensive and expose you to a significant amount of radiation.³⁶ Thus, the "risk/benefit" ratio doesn't fall enough on the benefit side to outweigh the risks, which is why no major medical organization has yet recommended screening CTs for current or former smokers.

My advice? Have a sit-down with your health care professional and ask (don't demand), based on your individual health history, for a list of screenings you should receive. Then follow the list closely, checking every few years for any updates.X

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