Is the physical examination really useless?

In 20 18, academician Han qide of Chinese academy of sciences put forward a subversive view in his report "disease risk factor control and disease screening"-"except for the elderly, whether people do physical examination has little effect on the final mortality rate." At present, the attitude of the medical profession towards physical examination is basically divided into two groups: one group thinks that regular physical examination can find health hidden dangers in advance and play a role in preventing diseases.

The other school thinks that physical examination is not only useless, but also causes physical injury, and it is unnecessary for people who are asymptomatic and have low disease risk index. & gt& gt& gt What is the truth? What does & lt& lt& lt physical examination mean? Physical examination is mainly divided into three categories:

1. Medical physical examination is a physical examination for the purpose of disease diagnosis and treatment because of the symptoms of the disease.

2. Social physical examination refers to the physical examination when entering school, entering a job, going abroad, joining the army or engaging in a special industry, which is based on a specific job or behavior.

3. Physical examination is a physical examination for healthy or sub-healthy people who are not sick, newly ill or about to get sick, or called "preventive health examination".

Physical examination can understand the health status of the examinee, make clear whether there are any abnormal signs in the body, and thus find out the disease clues and health hidden dangers early. Some abnormal signs belong to physiological variation (different from pathological variation, normal people can also appear, not diseases), and regular review is enough; Some abnormal signs may be disease risk factors, which need to be intervened and corrected by health promotion means; Moreover, some signs are the basis of disease diagnosis and need further examination and diagnosis.

80% of malignant tumors failed to occur in the early stage.

With the increase of age, the probability of human suffering from certain diseases will increase exponentially. Some special industries have to bear the risk of "occupational diseases", and the pressure of life is increasing, which leads to the spread of many diseases to younger groups.

Most of these diseases have no obvious symptoms in the early stage, but they often have serious consequences. For many diseases, early detection and timely treatment are the key to determine the prognosis.

At present, the disease with the highest annual mortality rate in China is malignant tumor. According to the current medical technology, 80%-90% of malignant tumors can be cured if they can be found early, and most early cancers can be eradicated by surgery and survive for a long time.

For example, the 5-year survival rate of early detection of primary esophageal cancer is 90%~95%, the 5-year survival rate of early gastric cancer is above 9 1%, the cure rate of early breast cancer is above 95%, the survival rate of early detection of cervical cancer can reach 90%, and the early intestinal cancer can be cured by 80%.

But unfortunately, almost 80% of malignant tumors were not found in the early stage. This is not because of our medical technology and medical level, but because some diseases have no symptoms in the early stage and are often easily overlooked.

According to the national cancer registration database, about 60% of cancer deaths in China can be prevented and avoided (65.9% for men and 42.8% for women); About 30-40% in developed countries. Some of them can be avoided by preventing factors that induce cancer, such as smoking, drinking and infection. Many early hidden diseases can also be found through regular physical examination, and early intervention can be carried out to control the development of diseases.

Physical examination is useless and harmful.

Many experts and scientific research institutions have different views on health examination. They believe that physical examination not only has no effect on reducing mortality, but also useless physical examination items will harm the health of normal people. Academician Han Qide of Chinese Academy of Sciences put forward a subversive viewpoint in the report of 20 18 "Control of Disease Risk Factors and Disease Screening": "Except for the elderly, whether people do physical examination has little effect on the final mortality."

In fact, only effective physical examination can play a role, otherwise frequent physical examination and too many physical examination items will only waste medical resources and endanger human health to some extent.

For example, receiving too much CT radiation due to excessive physical examination will increase the risk of cancer. For women under 2 1 year old and over 65 years old, some examinations such as cervical smear examination are unnecessary, but for non-children and non-pregnant women, taking chest X-ray as a routine physical examination will not harm their health.

In the process of physical examination, sometimes some benign results are exaggerated. Physical examination institutions or medical institutions use the asymmetry of knowledge to profit from it and guide patients to do expensive invasive surgery. Results No serious problems were found, which brought panic to the subjects and damaged their physical and mental health.

Therefore, it is best to rely on professional doctors to deeply interpret the physical examination report in order to obtain reliable health assessment and suggestions.

What is an effective physical examination?

Effective physical examination should be a combination of "basic+optional". Physical examination is not the more expensive and luxurious the package, the better, but the best choice.

Different people should have different concerns. After the physical examination of basic items, we will customize personalized physical examination items according to gender, age, occupation and family factors.

Physical examination should also be aimed at people with different risk factors (such as people with different occupations and family history). ), other projects can be checked every few years.

In addition, for people of different ages, the number of physical examinations each year is different.

Young people generally have a physical examination once a year; It is recommended that women of childbearing age have a physical examination every six months; People around the age of 40 should have a physical examination every six months, at least once a year; The elderly have a physical examination every six months, and after some indicators are abnormal, they have a physical examination every three months.