General health checks don’t work

General health checks have little or no effect on the risk of death from any cause or on the risk of death from cancer and probably have little or no effect on the risk of death from cardiovascular causes, according to a recent Cochrane review (Cochrane Database of Systematic Reviews 2019, Issue 1. Art. No.: CD009009. DOI: 10.1002/14651858.CD009009.pub3)

The review looked at 11 trials involving 233 298 participants, comparing outcomes in people invited to general health checks with those that were not. They analysed the effect on illness and the risk of death, as well as other outcomes that reflect illness; for example, hospitalisation and absence from work.

General health checks involve multiple tests in a person who does not feel ill. The purpose is to find disease early, prevent disease from developing, or provide reassurance. According to the Cochrane authors, the results are not unexpected as experience from screening programmes for individual diseases have shown that the benefits may be smaller than expected and the harms greater.

Lead author of the study, Lasse T Krogsbøll, says: ‘Systematic offers of health checks are unlikely to be beneficial and may lead to unnecessary tests and treatments. We can say this with a high degree of certainty.

‘One reason for the apparent lack of effect may be that primary care physicians already identify and intervene when they suspect a patient is at high risk of developing disease when they see them for other reasons. Also, those at high risk of developing disease may not attend general health checks when invited.’

In conclusion, the Cochrane researchers suggest the focus is shifted to the effects of structural interventions to reduce disease; for example, higher taxes on tobacco and alcohol, or restricting corporate advertising for harmful products.

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