10 Tests to Avoid

[imoldernu]

Choosing Wisely Campaign to Cut Unnecesary Medical Tests - AARP
10 Tests to avoid is the cover story of the newest AARP Bulletin, linked above.
The subtitle is:
"You may not need these common health exams as often as you think

As mentioned in some previous threads about AARP, the affiliation of Insurance Companies with the organization could infer a vested interest...

That said, the 10 tests are named, along with the reasons for making an educated decision about having the tests done. The headline is 10 tests to avoid, but common sense indicates that the tests will be necessary, depending on the circumstances.

One can only imagine the effect on the health provider profits on one side, and the insurance companies on the other.

[travelover]

Ironically, #10, an annual physical, is mandatory for my health insurance to get the preferred rate.

[youbet]

Good article. I generally agree with the comments.

[frayne]

Quote:

Originally Posted by travelover Ironically, #10, an annual physical, is mandatory for my health insurance to get the preferred rate.

The same here.

[MichaelB]

The 10 tests

1. Nuclear stress tests, and other imaging tests, after heart procedures
2. Yearly electrocardiogram or exercise stress test
3. PSA to screen for prostate cancer
4. PET scan to diagnose Alzheimer's disease
5. X-ray, CT scan or MRI for lower back pain
6. Yearly Pap tests
7. Bone density scan for women before age 65 and men before age 70
8. Follow-up ultrasounds for small ovarian cysts
9. Colonoscopy after age 75
10. Yearly physical

[redduck]

I really don't see a disadvantage of having a PSA test done once a year (#3 on the list). It is just a blood test (isn't it)? I have it done when I get my yearly physical (#10) when the blood is taken anyway. I also don't understand what the downside is to having a yearly physical. However, after talking to my MD, and due to my age, we have decided to discontinue the yearly Pap tests (#6).

[REWahoo]

Quote:

Originally Posted by redduck However, after talking to my MD, and due to my age, we have decided to discontinue the yearly Pap tests (#6).

Good idea. You're too old to be a Pap...

[redduck]

Quote:

Originally Posted by REWahoo Good idea. You're too old to be a Pap...

Yeah, you may have a good point there. Next time I see the doc, I'll ask him about the idea of discontinuing my birth control pills--or at least decreasing the dosage.

[Midpack]

Interesting, I certainly agree "we" have too many procedures, not too few in general.

I've shared my experience with PSA already in a recent thread. You can definitely get erroneous results and my GP and urologist would have acted on them had I let them, unnecessary expense, pain & risk.

And since I am otherwise very healthy (knock on wood), I have to have an annual physical or my GP will drop me, been there-done that. I don't see anything wrong with a simple annual physical as long as the patient is actively involved in anything that follows. I respect medical professionals and the challenges they face, but I won't just act on their recommendations without doing some research of my own. IMO we should be actively (but respectfully) involved in our own health care along with the professionals.

[photoguy]

I'm surprised they listed PSA but not mammograms. I guess they wanted to avoid that controversy.

[redduck]

Quote:

Originally Posted by Midpack Interesting, I certainly agree we have too many procedures, not too few in general. I've shared my experience with PSA already in a recent thread. You can definitely get erroneous results and my GP and urologist would have acted on them had I let them, unnecessary expense, pain & risk.

Regarding the PSA: my urologist has explained to me that he simply looks for trends re: PSA scores and it would be unusual for him to suggest any action unless a suspicious trend surfaced. So far, so good.

[Rich_by_the_Bay]

Quote:

Originally Posted by redduck I really don't see a disadvantage of having a PSA test done once a year (#3 on the list). It is just a blood test (isn't it)? I have it done when I get my yearly physical (#10) when the blood is taken anyway. I also don't understand what the downside is to having a yearly physical. However, after talking to my MD, and due to my age, we have decided to discontinue the yearly Pap tests (#6).

The risk of PSA is that of false positives (6/7 times for a healthy screening population) - the test comes back say 7 and that leads to unnecessary and expensive biopsies and sometimes surgery, which has its own risks. I have lost a couple of patients over the years to such a sequence of events, and many more to side-effects like bleeding and sepsis from "screening" test follow-up.

I could say the same for most screening test above.

[panacea]

I'm sort of surprised by the yearly check-up, at least at a certain age. Isn't that often how bigger problems are found? At age 45, I go bi-annually but planned to go annually starting at age 50. Is that really unnecessary??

[redduck]

Quote:

Originally Posted by Rich_by_the_Bay The risk of PSA is that of false positives (6/7 times for a healthy screening population) - the test comes back say 7 and that leads to unnecessary and expensive biopsies and sometimes surgery, which has its own risks. I have lost a couple of patients over the years to such a sequence of events, and many more to side-effects like bleeding and sepsis from "screening" test follow-up. I could say the same for most screening test above.

OK, but let's say the tests, over a three year period, trend up to 7, 9, 11. (If that's even possible, I really don't know much about this stuff).

[Mulligan]

I avoided going to doctor concerning number 5 (sharp lower back pain). I got hit twice in a year with back going out on me. First time I was bed bound for 3 weeks, the following year hit for a one week attack. GF was furious that wouldn't go to doctor. I kept telling her it would get better on it's own (even though I had no previous experience with this type of issue) and it did. Besides I knew I would more than likely be shipped off for an MRI and no interest in paying for it.


Sent from my iPad using Tapatalk

[razztazz]

Quote:

Originally Posted by redduck OK, but let's say the tests, over a three year period, trend up to 7, 9, 11. (If that's even possible, I really don't know much about this stuff).

It could mean cancer but what it most likely means your prostate is simply getting larger with age

PSA does not detect cancer. It just detects prostates

[Alan]

Quote:

Originally Posted by panacea I'm sort of surprised by the yearly check-up, at least at a certain age. Isn't that often how bigger problems are found? At age 45, I go bi-annually but planned to go annually starting at age 50. Is that really unnecessary??

I used to go for the annual company physical but since retiring I've only been going every 2 years. I had one in December and the Doc said to come back in 2 years, which I may or may not do.

[MtMan]

PSA testing raised a flag for me. Biopsy screen confirmed it. Prostatectomy removed it and further testing of the gland showed I was just in time. Had it not been for the PSA indicator, I would be facing a much more serious issue. I was 57 at the time.

A good friend on the other hand, did not do PSA. Visited his GP for some issues and was treated with an anti biotic for his prostate. Issues remained. Went to a urologist and had high PSA. Sample screening had a Gleason score of 9. MRI and other scans shows it is now in 5 areas of his body. Only option now is hormone treatment and that will only extend his live maybe 2 years. He is 70 now and zero health issues till this.

I will challenge anyone on the harm on getting a PSA test as a start. You cannot go on averages unless you want to roll the dice on your life and burden on your love ones.

[Midpack]

Quote:

Originally Posted by MtMan PSA testing raised a flag for me. Biopsy screen confirmed it. Prostatectomy removed it and further testing of the gland showed I was just in time. Had it not been for the PSA indicator, I would be facing a much more serious issue. I was 57 at the time. A good friend on the other hand, did not do PSA. Visited his GP for some issues and was treated with an anti biotic for his prostate. Issues remained. Went to a urologist and had high PSA. Sample screening had a Gleason score of 9. MRI and other scans shows it is now in 5 areas of his body. Only option now is hormone treatment and that will only extend his live maybe 2 years. He is 70 now and zero health issues till this. I will challenge anyone on the harm on getting a PSA test as a start. You cannot go on averages unless you want to roll the dice on your life and burden on your love ones.

Good thing PSA helped in your case. I'm only saying PSA test is not a be all, end all. Do a little research and you'll see how often a high PSA leads to an unnecessary biopsy or worse. I'd suggest Cleveland Clinic, Mayo, Sloan-Kettering, National Cancer Institute and American Cancer Society to start?

My GP and urologist scheduled a biopsy based on a PSA of 4.38 and fought my efforts to first retest PSA (a $50 test), even though I had no other symptoms or family history. By performing a DRE on me just before drawing blood, my GP may have (unwittingly?) caused my elevated but false PSA result.

[redduck]

Quote:

Originally Posted by razztazz It could mean cancer but what it most likely means your prostate is simply getting larger with age PSA does not detect cancer. It just detects prostates

Thanks razztazz, but I wasn't referring to me (or, to anyone one I know). I was just wondering what may make sense as to further PSA procedures. My doc told me he looks for PSA scores trending upward.

I'm thinking that having a PSA test is not a bad thing, but maybe the docs who interpret/misinterpret the results do cause some serious damage.