The UK government has announced this week that it is to roll out a screening programme – “Health MOTs” – checking blood pressure, height, weight, age, current medication, family history and whether a patient smokes and include a simple blood test to check cholesterol and, in some cases, sugar.
Patients with abnormal results will be offered advice, blood pressure drugs and/or statins.
Announcing the plans, Alan Johnson, the Health Secretary, said screening could save 2,000 lives a year
This is an old but much peddled nonsense.
The mortality rate for human beings is 100%. Everybody dies. Reducing the numbers of people dying from one particular disease inevitably increases the numbers dying from something else – people don’t die healthy! But there is virtually no debate at all about this. I’ve never read a single piece of research which asks the question – if less people die from heart disease and strokes, what will they die from instead? Does anybody know? Does anybody care? Well, they should do.
Let me be clear. If there are effective interventions and treatments for any diseases, we should use them. I’m not saying it would be good NOT to reduce heart disease. However, I’d like to know two things – firstly, those who have been treated after a heart disease risk factor is picked up in screening…….what life experience do they have? What diseases are increased in this group? (do we see more cancer, more dementia, more degenerative diseases for example?) And, secondly, more specifically what is the life experience of this group who are put onto drugs for decades after screening? (lifestyle interventions are likely to have positive impacts on a wide range of diseases, but drugs for preventing specific diseases only, at best, impact on those particular diseases)
I think that we need to start thinking of health, not in the short term, but from what has been termed a “life course” perspective. Without that, we are barreling in, at best, semi-blind.
My adopted mother, who’s battling throat cancer right now, tells this story about her gentleman friend who asks her periodically if she’s going to die. Her answer is “Yes, Bill, I am. And you know what? So are you!”
I really do think we’re looking at things the wrong way. I also think that my mother’s wonderful attitude is going to keep her around a bit longer than Bill’s worried she has….
I think attitude is the key, mrschili. I’ve just had a consultation with a 78 year old woman with recurrent cancer who completed her second run of chemotherapy last year and lost her husband to a stroke and she’s the brightest, liveliest, most cheerful and positive person I’ve met this week so far! An inspiration!