Disease screening ch

There is no need to follow the Internet celebrity list and arrange PET-CT, a complete package of tumor markers, and whole-genome sequencing. A personalized screening plan that matches your age, family history, and daily behavioral habits is the best solution that can really detect risks early without spending money in vain or even suffering unnecessary sins.

Last week, I accompanied my elders at the family to choose a package at the physical examination center. I met a young girl who had just worked for 2 years. She had just finished reading the "10 Cancer Screenings You Must Do at the Age of 25" guide in a book. She was holding on to her newly issued salary card and insisting on adding more than a dozen items to herself. The cancer screening program even includes the HE4 test for ovarian cancer, which is recommended by clinical guidelines for high-risk people over 40 years old. I reminded her a few words, but she also felt that I was reluctant to spend money to do something bad for myself, and she couldn't stop me.

In fact, the industry has been arguing about disease screening for more than ten years. One group is a supporter of the "early screening is omnipotent theory" and believes that as long as early and complete screening is done, all serious diseases can be nipped in the bud. The other group insists on the "screening is useless theory" and believes that the false positive rate of many screening items is too high, which can easily lead to over-medication and detecting all diseases without illness. Both sides have solid clinical data to support them, and no one can convince the other.

I met a 32-year-old man when I was doing health science popularization in the community. His father died of lung cancer before he was 50 years old. He was a smoker for 12 years. He has been doing low-dose spiral CT every year since he was 28 years old. Last year, a 6mm mixed ground-glass nodule was actually detected. After 3 months of follow-up, there were signs of slight enlargement. Minimally invasive surgery was performed in time. The pathological result was adenocarcinoma in situ. He did not even need chemotherapy. Now he has returned to work normally. This is a typical example of the benefits of early screening. But there are many negative cases. A while ago, a 27-year-old girl came for consultation. She had no family history of breast cancer and no symptoms of chest discomfort. She followed the trend and did a mammogram. It was found that there was a small calcification point. She was so scared that she cried for 3 days in a row. After a needle biopsy, she found out that it was just an ordinary benign hyperplasia and calcification. Not to mention that she received a shot in vain. During that time, she was so anxious that she even had irregular menstruation.

In fact, there is nothing wrong with what both sides said. The problem never lies in the screening itself, but in the matching degree. Take the PET-CT that many people are flocking to, for example, it costs 7,000 to 8,000 per time, and the radiation dose is several times that of ordinary chest CT. If you have no family history of cancer, no suspicious physical symptoms, and the tumor markers are completely normal, and it is purely a routine physical examination and you want to do a "full physical examination in one step", it is really cost-effective. Regular clinical guidelines will never recommend it as a routine screening item for ordinary healthy people. But if you already have unexplained weight loss, abnormally elevated tumor markers, or have a clear family history of hereditary cancer, then PET-CT is a powerful tool to help you accurately locate the lesions, and you won’t be able to save a penny of the money you have to spend.

I have been arranging screenings for my family members for so many years, but I have never directly chosen the most expensive "Diamond Package" or "Supreme Package" at the physical examination center. Every time, I make a list first and clearly list each person's age, past medical history, serious diseases of immediate family members, and whether they smoke, drink, drink or stay up late. Malignant Tumor Screening and Prevention Recommendations" are consistent. For example, my mother is 62 years old and has suffered from atrophic gastritis for many years. My grandmother died of gastric cancer. In addition to the routine physical examination items, I deliberately add gastroscopy, Helicobacter pylori testing, and pepsinogen every year. I never spend a penny more on other fancy "cancer prevention items" in the package.

There is another pitfall that many people easily fall into, which is that the higher the frequency of screening, the better. A friend of mine found a grade 3 thyroid nodule in his physical examination. He wants to have a thyroid B-ultrasound every month for fear of malignant transformation. In fact, as long as the grade is grade 3 or below and there are no suspicious signs of malignancy, an annual check-up is completely sufficient. Checking too frequently will not only increase your anxiety, but it has no practical significance. But on the other hand, if you are a hepatitis B virus carrier, you must have liver function, alpha-fetoprotein, and liver B-ultrasound at least every six months. You must not be lazy at this frequency.

Oh, by the way, don’t just beat the screening to death when you hear “false positive”. There was a popular view before that false positive will lead to over-medical treatment. This is true, but it must also be classified into serious diseases, such as lung cancer, gastric cancer, and cervical cancer. The cure rate is strongly related to the time of discovery. Even if there is a certain probability of false positive, as long as you are in a high-risk group, you still have to check. After all, the cost of a missed diagnosis is much greater than the cost of a false alarm.

To put it bluntly, disease screening is never a consumption that "the more expensive it is, the better for you". It is essentially a risk hedging that you do based on your own physical condition. There is no need to follow the online list, and there is no need to take chances. If you really don't know what you should check, register an account with a general clinic and spend more than ten yuan to let the doctor help you find the most suitable plan. It is more reliable than any internet celebrity strategy.