Health Care Professionals: what screening do you do to monitor your health?

[Crampulet]

Hello, I am interested in knowing what Health Care Professionals do themselves for their own health screening? Is it regular blood tests, ultrasounds, whole body mri, or something different? I am wondering what my best option is for screening at early 40s. Mammography doesn't start until 50, no lung screening seems to be offered as far as I know, gynecology is only smear which regularly goes unsuccessful at my GP anyway. I would like to consider private screening either in UK or abroad, but don't know what my best options are. Obviously budget will limit the choice as well, but don't know what is best worth. Thank you very much!

GP. Nothing out of the ordinary - smears basically, will go for mammograms when I get to that age. Most screening that isn't provided on the NHS is non evidence based and causes as many problems as it picks up. Certainly not a load of bloods and random scans - the companies that sell these prey on people's insecurities. They are a very good cure for an over-heavy wallet and not much else :-)

This is the issue, you could have a scan on Monday come back as negative and have a cell on Tuesday completely forget what it's doing and grow into a tumour eventually while you think everything is just fine.

OP@Crampulet if u r in the uk there’s currently a big study recruiting people…go to www.ourfuturehealth.org.uk …..even at this stage they are finding a lot of participants have undiagnosed type 2 diabetes, have high cholesterol or have high BP that they (and presumably their gps) are unaware of. It’s this sort of thing that there is value in checking out regularly, actively going looking for undiagnosed cancers or other illnesses is far far less beneficial (particularly as for certain cancers ,they may never prove problematic or the effects of treatment may prove worse than the cancer itself ),though it’s likely that ultimately we may well be offered blood tests that check for undetected cancers.

The health check - do I wait for an invite or go in and ask?

DH has had one this week (invite) but I have never had one (different GP surgery).

I have CFS so doing bloods would be quite useful to keep tabs on whats happening in there!

Very satisfied with my GPs management of my son’s health condition, was actually very unimpressed by my experience of Canadian community paediatricians when we lived there - the hospitalists were good, the community paeds had less knowledge than me, definitely far less knowledge than a UK GP, and spent their time doing vaccinations and baby checks (Ie work done by practice nurses and HVs here) rather than actually managing chronic health conditions.

If over 40 you can go and ask for a health check, but it's for cardiovascular health and nothing to do with CFS management.

OK DH had blood tests for liver function and other stuff, cholesterol etc

Yes, sugar, lipids, renal, liver and thyroid.

Not wanting anything to do with CFS management but I do think it is worth monitoring bloods as CFS symptoms could mask other stuff. And it could flag up any anomalies.

There is poor care for CFS patients in my view.

I suspect in the long run more testing would save money but yes unfortunately we're in the position where the service isn't funded well enough to have room for investing to make long term savings, a bit of a Vimes' boots situation.

The problem (again) is not that testing isn't funded, it's that most screening is not worth doing and doesn't save money, quite the opposite. The ones that are currently funded are worth doing.

That can change of course. Interesting stories today I think about possible blood test screen for dementia (presumably Alzheimers) which could be worth doing if the medication being introduced actually does something major to improve function or delay deterioration. But those stories are presumably coming from the press offices of charities whose job is to promote spending on their cause - not that that's wrong but the objective research on the value may not stack up.

https://www.theguardian.com/society/2023/oct/29/soaring-private-healthcare-use-pressure-nhs-gps

Why are you intending to get tests done for which there's no clinical indication? You're just increasing the pressure on the NHS.

False positive diagnoses resulting from tests there was no reason to perform are a significant cause of medical error [Zwaan L & Singh H (2015). Diagnosis 2, 97-103: https://doi.org/10.1515/dx-2014-0069].

Most random screening picks up diagnoses that would never have caused a problem, or incidental findings and doesn't save money. yes, the odd person gets something important picked up early, but the odds are against you being one of those few.

I take up the NHS screening I'm offered. That's it.

I do keep an eye on my weight and waist circumference ( crept up recently so lost a stone to avoid metabolic syndrome).

There are criteria for screening tests, to work out whether they are likely to be worthwhile or not:

https://patient.info/doctor/screening-programmes-in-the-uk

I don't do any extra screening. I think the current screening programmes are set at about the right level, and don't want to go round picking up incidentalomas that would never have caused a problem. Though I do need to get round to booking my first mammogram...

I agree about many types of screening but the ourfuturehealth early findings indicate that there are huge numbers of people who aren't getting issues like high blood pressure or cholesterol identified in good time, leading to soaring levels of type 2 diabetes and circulatory problems that could have been treated far more cheaply if caught earlier.

Well, it's interesting that over the thread, the one thing that several HCPs are doing is to monitor their blood pressure in some form, and to take lifestyle measures to optimise it. So that fits already with the ourfuturehealth message. My dp has joined it and I've hot it on my list to do. If more genuinely helpful screening ideas come out of it, that's good, but I am not going to jump ahead of the results.

I guess I would also regard trying to see the dentist reasonably regularly as a screening measure in some ways, given the close relationship between gum health and general health. But that's a lot more difficult for most people.

Cervical screening has reduced the incidence of cevical cancer by about 90%, definately cost effective.

Newborn blood spot screening has almost elimated hypothyroidism as a cause of learning disability.

Screening can save lives.

But that's not random screening - those programmes are publicly funded because they save lives and the NHS actively seeks to do those screens. Random screening is deciding with zero symptoms to pay for bloods or scans of various types that aren't publicly funded or recognised as useful in specific contexts.

Yes, evidence based screening saves lives.

Random scans and bloods don't.

"Yes, evidence based screening saves lives"

That is exactly what I am trying to get at. HCPs will know about these sort of evidence before the practice is adopted by the NHS, so may seek it privately or other routes and I wondered what these may be. Like previous posters saying doing an ECG for their child or sourcing HPV vaccine privately for their son before it was offered on the NHS. To be honest, I expected people saying they would start breast screening earlier than 50 given in some other countries it starts at 40, which I would imagine must also be evidence based.

@volunteersruz Thank you for the Our Future Health link, will look into it!

I think mammograms are fairly finely balanced - the more screening you do, and the younger you do it, the more false positives you get, which lead to huge anxiety and unnecessary biopsies etc. The benefits/false positives balance makes screening less appropriate for under 50s:

• The evidence showed that mammography reduced breast cancer mortality in women aged 50–69 years (high certainty) and women aged 70–74 years (high certainty), with smaller reductions in women aged under 50 years (moderate certainty).
• Mammography also reduced stage IIA+ breast cancer in women aged 50–69 years (very low certainty) but resulted in an overdiagnosis probability of 23% in women aged under 50 years and 17% in those aged between 50–69 years (moderate certainty).

https://cks.nice.org.uk/topics/breast-screening/background-information/benefits-harms-of-the-screening-programme/

Yes absolutely, there are lots of questions over mammography but they are a lot better than random scans!

Random ECG isn't evidence based, unless there's a family history of sudden cardiac death in which case you need a detailed echo and someone who knows how to interpret it.

Vaccines aren't screening but yes, when Cervarix was chosen as the first HPV vaccine, and for girls only, all the doctors I know got their kids (boys and girls) vaccinated privately with the much better Gardasil.

I got my kids an early MMR as they went to nursery before the age of 1 at a time when the number of idiots who didn't vaccinate was about as high as it is now and so they wouldn't have been protected against herd immunity

Lots of drs vaccinate their children against chickenpox

but none of that is screening! so the way you asked the question probably meant you didn't get the answers that you were after........