A group of British physicians has gotten so fed up with private, for-profit companies peddling unnecessary and potentially harmful health screenings to an unsuspecting public, they’ve launched a new website to help people know what questions they should ask before signing up (and handing over their hard-earned money) for such tests.
Although aimed at Brits, American consumers will also benefit from the information provided on the website, which is called Private Health Screening (although you’ll need to know that the acronym NHS stands for the U.K.’s free National Health Service).
“Private health screening tests are oversold and under-explained,” writes one of the creators of the website, general practitioner Dr. Margaret McCartney, in the Guardian newspaper. “Health screening can cause more harm than it prevents, so companies have a duty to provide full information to customers.”
The health screenings criticized by McCartney and her colleagues on the new website are not the ones physicians give to people who have symptoms or are at high risk for a particular illness or condition. The website’s creators are instead challenging the screenings (usually ultrasounds, ECGs and blood tests) that private companies sell to healthy people to “check” for heart disease, aneurysms, high cholesterol, type 2 diabetes, osteoporosis and other ailments. The companies sweep into a city or town (or British village) and set up temporary screening clinics, often in church basements, community halls or shopping malls. After a day or two, they move on to a new location.
McCartney and her colleagues feel those companies are not giving consumers full and fair information about the screening tests for which they’re charging up to $300.
“[S]creening — testing well people as opposed to people who already feel unwell or who have symptoms, like a lump, or palpitations — always has the potential to harm, and is a constant balance of pros and cons,” she writes. “There is a risk of false positives, false negatives and false reassurance, and the problem of sometimes giving people a diagnosis they don’t need, or subjecting them to treatment they won’t benefit from. Noninvasive tests may cause few hazards, but the way the knowledge from a positive or negative scan is used may result in harm to the patient for no benefit.”
McCartney offers this example:
Take for example scanning the carotid artery — the main artery in the neck — which Life Line Scanning [sic] offers to completely well people. [Life Line Screening is the primary company that peddles private screening tests, both in the U.K. and in the U.S.] This is a useful test for people who have had a stroke, because if they have significant narrowing on the scan, an operation to clear this can reduce the future risk of stroke due to narrowed arteries.
However, there are risks associated with the surgery used to clear the blockage — not least, ironically, a stroke. This may be a reasonable risk to take if the chance of stroke caused by the carotid narrowing is high. But for people who haven’t had a previous stroke or a ministroke, the risks of causing harm outweigh the chances of benefit, which is why the UK National Screening Committee doesn’t recommend that the NHS provides it. It is not a case of the NHS being mean, it is simply that it is not a good test. For people who haven’t had a stroke, the risk of stroke or death during the operation is about 3%.
The new website has a wonderful section in which the physicians comment on the claims and other statements made in the advertisements produced by the for-profit screening-test companies. Click on one of the ads (which are similar to those used in the U.S.) and up pops the physicians’ annotated version.
Here, for example, is a paragraph from an ad:
To help detect your risk of stroke a 10 minute scan of your Carotid arteries examines blood flow to your brain, and “plaque.” (“Plaque” is the term for fatty deposits that can build up in your arteries, without showing any symptoms.)
And here is the physicians’ comment on that paragraph:
Carotid artery screening for people without a history of stroke or ministroke isn’t done in the U.K. because it causes as many problems as it prevents.
Making evidence-based decisions
Next time you receive a direct mailing or see a flyer about these private health screenings, compare it to the information on www.privatehealthscreen.org. Among the information is a list of articles about the ethics as well as the science of health screening.
“[S]creening is often counterintuitive and harmful,” writes McCartney. “Because of these inherent problems, people need to make good choices about whether to be screened based on evidence.”
(Hat tip: HealthNewsReview)