What items should be checked in a routine physical examination

There is no fixed unified list for routine physical examination. The core is a combination of "basic required items + individualized additional items". The basic items are the core screening content that must be covered by all people. The additional items should be adjusted based on age, occupation, past medical history, and family history. There is no need to blindly pursue the most comprehensive items.

When I helped the company make an employee physical examination plan last month, I also talked about this issue with the doctors at the physical examination center. Many people wanted to add all the expensive items, but left out the core basic items. In fact, the basic items are not complicated to say. They are the most common basic physical examinations such as height, weight, blood pressure and heart rate, three routine blood, urine and stool tests, including liver and kidney function, blood lipids, fasting blood sugar and uric acid biochemistry, as well as ultrasound of liver, gallbladder, pancreas, spleen, kidney and thyroid. For women, breast and gynecological ultrasound are added, for men, prostate ultrasound is added, plus lung imaging examination. When it comes to lung examinations, there are actually different trends in the industry. For people under 40 years old, with no history of smoking, and no family history of lung cancer, ordinary chest X-rays are enough. The radiation dose is extremely low and cost-effective. However, if you are over 40 years old, or have smoked for a long time, or have family high-risk factors, more doctors now recommend direct low-dose lung CT. The missed diagnosis rate is much lower than that of chest X-rays. Although the radiation dose is slightly higher, it is still within the safe range.

Uncle Zhang, who lived downstairs in my house last year, was a typical example. He was usually reluctant to spend money for physical examinations. This year, he couldn't resist and signed up for the cheapest basic package. A stool test showed positive for occult blood. A colonoscopy was performed and early-stage intestinal cancer was discovered. After minimally invasive surgery, he is recovering very well. If he had removed the stool in order to save dozens of dollars and waited for blood in the stool to be checked again, the disease might have been delayed to the mid-to-late stage.

As for the tumor marker screening that everyone is struggling with, there is currently no unified conclusion in the industry. One school of thought believes that when ordinary healthy people undergo tumor marker screening, most of the elevated indicators are caused by factors such as inflammation and irregular work and rest. On the contrary, it will only increase anxiety and is an over-examination; another school of thought believes that high-risk people with a family history of cancer Targeted testing of specific markers can play an early warning role. Therefore, it is not necessary for ordinary people to have a full range of tumor markers for physical examination. If a direct relative has suffered from a certain type of cancer, just add the corresponding single item in a targeted manner. For example, if you have a family history of liver cancer, check for alpha-fetoprotein, and if you have a family history of gastric cancer, check for pepsinogen. It is cost-effective and will not waste money.

Young people who often stay up late and eat takeout can definitely add a carbon 14 breath test to check for Helicobacter pylori in addition to the basic items. If office workers who often sit in front of the computer for more than ten hours often suffer from shoulder and neck pain, there is no need to spend hundreds of dollars to take a cervical spine MRI. First, take dozens of frontal and lateral cervical spine X-rays to screen out whether there are problems with straightening of curvature or bone hyperplasia. If there is any abnormality, it is not too late to do further MRI.

If you are really not sure what items you should add, when you go for a physical examination, spend an extra three to five minutes chatting with the consulting doctor at the front desk and explain your situation clearly. The items they choose for you are much more reliable than those fancy luxury packages you choose blindly.