What is the best time for disease screening?

In fact, there is no uniform best time for screening that applies to all diseases. The development patterns of different diseases are different, and the risk of disease varies greatly from person to person. The truly appropriate screening node is essentially the window period when the risk of disease is significantly increased and screening methods can detect early reversible lesions. Spending money too early will only increase anxiety, while if it is too late, the best opportunity for intervention may be missed.

I have been in the physical examination center for almost 8 years, and I have seen too many people who either rushed to their early twenties and had gastrointestinal endoscopy and chest CT every year, or waited until they were sixty or seventy years old when their bodies started to show symptoms before they remembered to check tumor markers. In fact, it is not necessary. Take cervical cancer as an example. The current domestic and foreign guidelines basically make it clear that it is enough for sexually active women to start TCT and HPV combined screening at the age of 21. If there are no abnormalities, it is enough to have a test every 3-5 years. I met a 28-year-old girl a while ago who had just been married for two years. She had never done relevant screening before, and the unit test showed that HPV16 was positive. Further biopsy showed low-grade intraepithelial neoplasia. If she had started screening at the age of 21 according to the regulations, the infection could have been detected earlier, and she would not have been so scared that she could not sleep for several days when she got the results.

There are now many controversial screening points in the industry, such as the starting age for breast cancer screening. European and American guidelines generally recommended starting mammography at the age of 50. Many clinicians in my country have combined the characteristics of local women’s incidence—the peak incidence is about 10 years earlier than that of European and American women. It is recommended to start annual breast ultrasound combined with mammography screening at the age of 40. There is also a view that women with no family history and no history of benign breast disease can start at the age of 45. There is no absolute right or wrong in either view. The core depends on the individual's risk of disease. There is also the screening time for gastrointestinal endoscopy. In the past, the general recommendation was to have the first screening at the age of 45. Now more and more doctors recommend that if you eat a high-fat and high-salt diet all year round, have Helicobacter pylori infection, or have an immediate family member with a history of gastrointestinal cancer, you can do the first screening at the age of 35-40. If there are no abnormalities, you can just re-examine in 5-10 years. There is no need to suffer from it every year.

In fact, this matter is similar to picking seasonal fruits. Strawberries are best picked when they have just turned red and are about 70 to 80% ripe. They are too sour and too ripe, and they are easy to spoil. The screening time for different diseases is also to find the node "when problems are about to occur but have not developed out of control." There is no need to blindly follow the general timetable online. If you are really unsure, tell the doctor clearly about your living habits, past medical history, and family diseases when you go for a physical examination next time, and let the doctor help you decide.