Kim The core logic of disease screening is not to collect items and seek completeness but to do personal risk stratification based on age, gender, family history, past physical condition, and living habits, and then select corresponding items in a targeted manner to achieve the highest accuracy and cost-effectiveness.
Many people come up with a full-body physical examination package that costs tens of thousands of dollars, and even arrange PET-CT. In fact, it is really unnecessary. Unless they have a clear risk of multiple tumor metastases, ordinary healthy people will not be worth the gain by doing this type of high-dose radiation examination. For people who are over 35 years old, have been smoking for more than 10 years, smoke more than 1 pack a day, and have direct relatives with lung cancer, a low-dose spiral CT is enough to screen for lung cancer. The radiation dose is only one-third of that of ordinary CT, and the detection rate of early lung cancer can reach more than 90%. It is much more reliable than a chest X-ray, and there is no need for more expensive examinations.
I have to mention here that there are currently different opinions in the industry on whether ordinary healthy people should routinely check tumor markers. One group thinks that the false positive rate of such tests is too high. People often suffer from anxiety for half a month because of a slight increase in a certain indicator. They go back and forth with various invasive tests and finally find out that it is just staying up late or suffering from inflammation. They just suffer.； The other group believes that if you have high-risk factors for cancer, using tumor markers as auxiliary reference items and making judgments based on images and physical signs can provide an additional layer of early warning, and you cannot directly implement all such projects at once.
When I was doing health education in the community, I met a 43-year-old woman who weighed 18 pounds more than the standard. Both her mother and grandmother had breast cancer before the age of 50. Her previous physical examinations every year were the basic package provided by her employer, and she had never added breast ultrasound or mammography. Last year when I was taking a shower, I felt a hard lump in my right breast, so I went to a specialist for a check-up. It was already in the middle stage of invasive breast cancer. If these two screenings had been targeted based on her family history and weight two to three years earlier, there was a high probability that the cancer would have been discovered at the stage of carcinoma in situ, and the prognosis would have been completely different.
Not all screenings have to be done in tertiary hospitals. For basic screenings for common diseases such as hypertension, diabetes, and chronic hepatitis B, the equipment and results of community health service centers are accurate, and there is no need to wait in long lines.； However, if you want to do items such as gastroenteroscopy, low-dose spiral CT, cervical cancer TCT+HPV combined screening, which require a high level of doctor operation and film reading experience, try to choose a medical institution that usually does a lot of such screening. Otherwise, early small polyps and tiny nodules can easily be missed, and the screening effect will not be achieved even after spending money.
To put it bluntly, disease screening is like "clearing mines" for the body. Instead of wandering around with a detector to scan the entire map, you should first find out whether your land has been mined before, whether the land of people around you has been mined, and whether you always run to places prone to mines. First, identify small high-risk areas and then scan accurately. This will neither waste money nor miss the hidden dangers that are truly hidden. If you are really not sure what kind of screening you should do, chatting with a doctor in a general practice or health management department for 10 minutes is much more reliable than searching online for half a day and buying a random package.
