Watch out! What do medical examinations mean?

Medical examinations have a specific purpose: doctors look to see if a patient is healthy. Medical examinations are also carried out on people who think they are ill. If pockets of illness are found, treatment is prescribed. To maximize the benefits of health checks, the majority of the population is checked systematically. This is in the ideal case.

But the ideal exists far from always. There is chaos and uncertainty in health checks. Recommendations are far from always implemented.

This is because even self-interest plays a role. For prostate cancer, for example: an independent panel of experts from the Swiss Medical Council rejected the so-called PSA test for the early detection of cancer in asymptomatic men without risk factors. The test proved unsuitable in part because, despite PSA detection, a number of neoplasms requiring treatment remained undetected.

The Swiss Society Urology, on the other hand, conducts its tests. Not as "non-critical mass screening" but as part of individual cancer screening. This is not surprising. Critics claim that urologists and labs are making money off these tests.

Is it helpful or harmful? This is an important question for epidemiologist John G. Schmidt. To him, it's clear that the harms of a quick but poor-quality test can outweigh the speed factor. Especially when it comes to "overdiagnosis," when there is an examination and unnecessary interventions for a frightened patient. According to Schmidt, one should always keep in mind that all tests, whether they are imaging or tissue analysis, can be flawed.

Without systematic physical exams, people will live carefree and quietly for a while, already having a disease. According to Schmidt, something is wrong in medicine if there are no examinations in patients without complaints. Fact: "Pathologic changes can occur in anyone." Thus, the possibility of getting prostate cancer is inherent in most men.

According to various studies, this disease can occur on its own in one in three or four men over the age of 50. Those over 80 have a much higher chance of getting the disease. But 85 percent "die with cancer, not from cancer," says German psychologist Gerd Gigerenzer. Nevertheless, many people are willing to undergo medical screenings, even though the procedure is risky and may even cause impotence or urinary incontinence.

What are the benefits of screening actually? Dr. Schmidt shared information from two controlled groups of subjects. Comparisons have repeatedly shown: cancer mortality is only minimally reduced. For mammography: in women, detecting cancer early is a big deal, roughly a 1 in 1000 chance.

So is everything useless? "No. But we shouldn't use all indiscriminate screenings for thousands of healthy people," says Marcel Zwalen, a doctor of preventive medicine. He favors a national and independent body that would review studies and make binding recommendations for certain tests.

For cervical cancer: on the one hand, many women are subjected to research too often. Routine business for gynecologists. And hardly anyone is interested in breaking this vicious cycle. But there are also women who don't know about testing. Foreigners and those who are 45 and older. For Marcel Zwalen, it is simply unbelievable that the list of checks and tests is constantly growing. At the same time, there are entire populations that don't get tested. Half of the women who develop cervical cancer have never been screened.

To measure blood pressure: men and women in their 20s every three to five years.

To measure cholestero: Men ages 35 to 65, women ages 45 to 65, every five years. In patients with risk factors for cardiovascular disease after diagnosis.

screenin diabetes: men and women 45 years of age and older every three years. Especially when risk factors such as hypertension, obesity, type 2 diabetes mellitus in the family, diabetes mellitus during pregnancy are present.

Glaucoma screening (Glaucoma): men and women over 50 years of age every two to three years. After 40, patients at risk (glaucoma in the family, obesity, high blood pressure, severe myopia, long term steroid treatment).

Smear (PAP): Sexually active women in their early 20s. Second smear after one year and then every three years thereafter. After 65 only if high risk.

Colonoscopy: men and women over 50 every ten years to 70 years in high-risk patients (colon cancer in the family, chronic inflammatory bowel disease, colon polyps) every five years, respectively, in consultation with a physician.

Mammography (breast cancer) For women without any risk factors, there are no policy recommendations for screening. For women over 40 with risk factors (family history) every two years.

PSA (prostate) testing: no recommendations for men without risk factors. In men with family history (first relative degree, who are younger than 65 years or more, with first degree relatives regardless of age of prostate cancer) : test from 50 years of age respectively ten years before diagnosis in relatives.

Colon (hidden blood) a very specific test, recommended only when patients have had a positive colonoscopy test.

When risk factors and symptoms are absent, the following medical examinations are not necessary:

Pulmonary function tests
Pulmonary function
Urine test
Determination of tumor markers
ECG and stress ECG
Abdominal ultrasound (USG)