General health checks do not reduce risk of dying from heart attack, stroke, cancer or dying overall

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Thursday, January 09, 2020 2:03 pm Email this article

General health checks do not reduce the risk of dying from heart attack, stroke, cancer or dying overall over some number of years according to an updated review by Prof. Peter Gøtzsche, MD and two other authors from the Nordic Cochrane Centre.

 

People given general health checks were 2% less likely to have a fatal or non-fatal heart attack during the study periods although the results were not statistically significant, meaning the difference could be due to random chance.

People given general health checks were 0% less likely to die during the study periods.

People given general health checks were 1% MORE likely to die from cancer during the study periods although the results were not statistically significant, meaning the difference could be due to random chance.

People given general health checks were 5% MORE likely to die from heart attack or stroke during the study periods although the results were not statistically significant, meaning the difference could be due to random chance.

People given general health checks were 5% MORE likely to have a fatal or non-fatal stroke during the study periods although the results were not statistically significant, meaning the difference could be due to random chance.

Definition of General Health Checks

General health checks to identify signs, symptoms, or risk factors for disease that were previously unrecognized

[Note: These quotes are from their 2012 review since I have not seen a copy of the full updated 2019 review.]

“General health checks involve a contact between a person and a healthcare professional to identify signs, symptoms, or risk factors for disease that were previously unrecognized,” the paper notes.

“They are combinations of screening tests, few of which have been adequately studied in randomised trials. For example, although the benefits and harms of treatments for conditions such as hypertension and diabetes have been extensively studied in randomised trials, screening asymptomatic people for these conditions has not.”

“General health checks involve multiple tests in a person who does not feel ill with the purpose of finding disease early, preventing disease from developing, or providing reassurance.”

Medical Interventions Can Cause Harm

All medical interventions can lead to harm

“While we cannot be certain that general health checks lead to benefit, we know that all medical interventions can lead to harm,” the authors note.

“Possible harms from health checks are overdiagnosis, overtreatment, distress or injury from invasive follow-up tests, distress due to false positive test results, false reassurance due to false negative test results, possible continuation of adverse health behaviours due to negative test results, adverse psychosocial effects due to labelling, and difficulties with getting insurance.

“Last but not least, organised programmes of general health checks are likely to be expensive and may result in lost opportunities to improve other areas of healthcare.”

Conclusion

Conclusion: General health checks do not reduce the risk of death or disease

“General health checks did not reduce morbidity or mortality, neither overall nor for cardiovascular or cancer causes, although they increased the number of new diagnoses,” the paper concludes.

“With the large number of participants and deaths included, the long follow-up periods used in the trials, and considering that death from cardiovascular diseases and cancer were not reduced, general health checks are unlikely to be beneficial.”

Reference

Krogsboll LT, Jorgensen KJ, and Gotzsche PC. General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database Syst Rev, 2019 Jan 31; 1: CD009009.

The abstract is posted here.

Author’s Contact Info

Lasse T. Krogsbøll, MD
Nordic Cochrane Centre
Rigshospitalet Department 7811
Blegdamsvej 9
2100 København Ø, Denmark
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