How to check for disease screening

The core logic of disease screening is to "determine the risk first and then choose the items." The more items and the more expensive the better, it is never better. Finding the right items that match your physical condition is 10 times more effective than doing a complete set at random.

I met a 32-year-old man before. He had been smoking for 10 years. Every year, he chose the most expensive package for his physical examination at work. More than ten tumor markers were checked and all were normal. Last year, he had a cough for half a month and went to the hospital. The doctor asked him to do a low-dose spiral CT. Then an 8mm ground glass nodule was found. Fortunately, it was early cancer, and it would be fine if it was removed. His previous package did not include this most targeted project for people at high risk of lung cancer, so he spent a lot of unjust money and almost missed a big problem.

Speaking of this, I have to mention the PET-CT screening that everyone is making the most noise about now. There are also different opinions in the industry: Some people believe that it is highly sensitive and can detect tiny lesions that cannot be found by ordinary CT. It is suitable for people with sufficient budget and a clear family history of cancer.； However, more radiologists in tertiary hospitals will advise ordinary healthy people not to do it casually. The amount of radiation for one examination is equivalent to 7-10 conventional chest CTs. For people without high-risk factors, the potential risks brought by radiation are higher than the benefits of detecting the problem. There is no need to bear this unnecessary risk.

In fact, before you go to get a screening test, you can check the situation yourself: Are there any immediate relatives in your family who have suffered from genetic diseases such as cancer or cardiovascular and cerebrovascular diseases? Do you have any habits such as smoking, drinking, staying up late all year round, or eating heavy foods? What are the most common diseases according to age and gender? It is much more efficient to clearly tell the ordering doctor this information than to choose the package by yourself for a long time. For example, women whose mothers or sisters have had breast cancer before menopause can definitely advance their breast screening age to 35 years old. They do not need to stick to the universal standard of 40 years old before starting screening. ； For people who eat takeout every day and drink every meal, it is much more useful to pay more attention to liver function and gastroscopy than to check a bunch of unpopular tumor markers.

Two months ago, a 28-year-old girl came for screening. Both her parents had coronary heart disease in their 40s. She weighed 160 pounds and usually sat at work for 12 hours. The routine electrocardiogram showed all normal. I suggested that she undergo a coronary CTA. As a result, she already had mild blood vessel stenosis. Taking medicine to control it early can completely avoid the development of myocardial infarction later. To put it bluntly, disease screening is like a security check for your home. Only those who have installed gas need to focus on checking the gas pipelines, and only those who live on low floors need to pay attention to anti-theft windows. Everyone cannot follow the same standard. Not to mention the cost, it is easy to miss the areas that really need attention.

There is no need to be overly nervous. For ordinary people without high-risk factors, it is enough to do basic routine hematuria, liver and kidney function, ultrasound, and chest X-rays every year, plus screening for high-risk diseases corresponding to gender and age, such as HPV+TCT for girls and prostate ultrasound for middle-aged men. Over-screening can easily detect trivial problems, which is unnecessary to scare yourself.