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On trial: regular medical checks

New Delhi, Nov 20: People with no health complaints are unlikely to benefit from regular medical checks, a study has indicated, questioning a long-standing dogma that looking for early signs of looming disease always saves lives.

The international study has found that regular medical checks to identify hidden signs of disease do not always reduce the incidence of illness or deaths from heart disease or cancer.

Doctors say the study, conducted in Denmark, may be relevant to countries where health checks are promoted. In India, some private hospitals and clinics have been known to urge people to take regular health checks.

The study, to be published tomorrow in the British Medical Journal, pooled the results of 14 earlier trials covering more than 76,000 people in western Europe and North America who had regular medical checks and 106,000 people who had not.

The researchers found no evidence of benefit from regular checks and no reduction in deaths from heart disease or cancer, where early screening would have been thought likely to make an impact.

“We wanted to explore the balance between benefits and harms of general health checks,” Lasse Krogsboll, principal investigator at the Nordic Cochrane Centre in Copenhagen, told The Telegraph. “We found no benefits.”

The study, however, found that regular medical checks led to more diagnoses and more medical treatment for conditions such as high blood pressure. But, Krogsboll said, as the treatment did not improve the incidence of illness or the number of deaths, this is “over-diagnosis” and “should be treated as a harm rather than a benefit”.

He said the results of such trials might vary from population to population. It is possible, for instance, that some people with access to primary health care — and good health care services — may not benefit from regular screening while some, deprived of even basic health care, may.

“The key message seems to be that walk-in health checks are not cost-effective, although these results cannot be directly extrapolated to individuals,” said Nikhil Tandon, senior endocrinologist at AIIMS, New Delhi, who was not associated with the study.

“The results suggest that a better screening strategy would be to set some criteria for regular health checks — perhaps people above 45 or people with a family history of certain diseases, or people who are overweight.’

Krogsboll and his colleagues say there are several possible explanations for their findings.

One possibility is that preventive medication such as cholesterol-lowering drugs or medicines to treat high blood pressure have less benefits among the general population than among patients already diagnosed with a disease.

The people who had taken part in the 14 trials analysed in the study had regular health checks that looked at blood pressure, cholesterol readings, blood biochemistry and blood sugar, among other tests.

Tandon said the study results appear intended for health policy makers. “But even in the case of individuals, regular screening is likely to be cost-effective if it is done with some risk criteria in mind,” he said.