General health checks do NOT reduce the risk of death over 4-22 years

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Wednesday, March 09, 2016 1:29 pm Email this article

General health checks do NOT reduce the risk of dying over the next 4 to 22 years according to a Cochrane systematic review and meta-analysis of studies.

Risk of Death

General health checks associated with 1% lower risk of death, but not statistically significant

“Nine trials reported on total mortality, and our meta-analysis included 155,899 people and 11,940 deaths. The median length of follow-up was nine years (range 4–22 years)... We did not find an effect of general health checks on total mortality, risk ratio 0.99… [that is to say that those who got general health checks were 1% less likely to die over the next 4-22 years, but this was not statistically significant],” the paper notes.

Definition of General Health Checks

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

“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.”

References

Krogsboll LT, Jorgensen KJ, Gronhoj Larsen C, and Gotzsche PC. General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database Syst Rev, 2012; 10: CD009009.

Krogsboll LT, Jorgensen KJ, Gronhoj Larsen C, and Gotzsche PC. General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis. BMJ, 2012; 345: e7191.

Author’s Contact Info

Lasse T Krogsbøll
Nordic Cochrane Centre
Rigshospitalet
Blegdamsvej 9
2100 Copenhagen, Denmark
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