k12974005Ultrasound scan of human liver

Perhaps you’ve seen ads or brochures offering packages of diagnostic ultrasound screening tests that offer “high quality” tests that may “save your life” in a nearby location at bargain prices.

The package usually includes ultrasound tests for stroke, abdominal aortic aneurysm, atherosclerosis, osteoporosis and even ovarian cancer.

The ads and testimonials claim you have nothing to lose, but so much to gain.

What can you lose?  Plenty, says the Editorial Board Chair of the UCB Wellness Letter, John Swartzberg, MD.

From this point on, I’m going to quote, rather than edit and paraphrase, the good doctor’s precise and succinct explanation of the dangers of consenting to ultrasound testing of the non-symptomatic general public:

“What could be wrong with getting tested, just to be on the safe side?

Let me count the ways.

False-alarm factor:  One drawback of any diagnostic test is that it may suggest there is disease when, in fact, there is none.  When low-risk people are screened, the odds of such false-positives increase dramatically.  If an ultrasound screening test finds something “abnormal,” you’ll have to undergo further tests, which may be invasive and expensive.

False-assurance factor:  The tests can fail to discover real problems, and thus give you a false sense of security.  Why bother controlling your cholesterol, you might think, if your arteries look fine on an ultrasound?

Money factor:  Insurance seldom pays for this type of indiscriminate screening.  A few hundred dollars may seem reasonable, but it’s likely to be money wasted.  Also, companies offering “bargain” tests often urge you to repeat them, sometimes yearly.

Quality factor:  The tests may not be good quality or be carefully administered by licensed sonographers.  Results may be reviewed by unqualified technicians.  Some centers take time to talk about results, other simply hand out reports with no explanations.

Emotional factor:  A round of follow-up tests that turn out to be needless can cause weeks of worry.  Even if some small problem is detected, the right course of action may be hard to determine.

Some incidental finding may cause you months or years of anxiety and then prove to be nothing.  Overdiagnosis and overtreatment are nearly as big a problem as underdiagnosis and undertreatment in our health care system.

These “packages” promise a lot, but are far more likely to deliver anxiety and even suffering than the “peace of mind” they promise.

The pitch advises you to take charge of your health care.  Sometimes that means resisting the siren call of scattershot testing.

Rather than going to some screening center, talk with your doctor or other primary care provider about which tests you really need.  Our online guide to preventive services (WellnessLetter.com/screening) presents the basics.”

Source:  University of CA, Berkeley Wellness Letter, May 2013


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