Routine physical examination is fine. Is everything okay?

I have been doing health education in a community health center for almost 6 years. I have met too many people who asked "Why am I still feeling uncomfortable" with perfectly normal physical examination reports? Let me give you an accurate answer: there is nothing wrong with the routine physical examination, but it does not mean that the body is completely fine.

Last year, I met a 32-year-old Internet operator who came to make a referral. He had just completed the regular group examination at the unit in the past three months. The blood test, abdominal B-ultrasound, and chest X-ray were all within the qualified line. He did not even have fatty liver, which is common among young people. The result During that time, I kept having acid reflux and belching, and even after taking stomach medicine for almost two weeks, I was referred for a gastroscopy. It was found that it was low-grade gastric intraepithelial neoplasia, which is an early cancer. Fortunately, it was discovered early, and the disease was resolved by endoscopic resection without even the need for chemotherapy. He was very puzzled when he took the physical examination report, saying that I had just completed the physical examination for three months, why did something go wrong? In fact, the answer is very simple. His routine physical examination did not include gastroscopy at all. He only tested for Helicobacter pylori and it was still negative. Of course, early lesions of the gastric mucosa could not be found.

To be honest, many people have too high expectations for routine physical examinations. It is essentially a universal basic screening. Just like when you do a basic annual inspection of your car, it will only check general items such as lights, brakes, and tire pressure.

Of course, this does not mean that routine physical examinations are IQ taxes. Recently, we have encountered many examples of the opposite. There was a 40-year-old truck driver who had 3+ occult blood levels in his urine during a routine physical examination organized by his work unit. He had no symptoms of back pain or blood in his urine. We followed up and referred him, and finally found out that it was early-stage kidney cancer. After laparoscopically removing half of the kidney, he was fine. If he had waited until he had symptoms to check, he might have already advanced to the mid-to-late stage. Routine physical examinations are originally aimed at high-risk diseases such as hypertension, diabetes, abnormal liver and kidney function, and obvious organ nodules. Screening out these can already cover 80% of common health risks. To say that it is useless is really an understatement.

People often ask me, what should I pay attention to when getting a normal physical examination report? In fact, the most important thing is not to use it as a "gold medal to avoid death". If you have persistent uncomfortable symptoms, don't bear it. For example, a person who smokes all year round always coughs. Don't take it seriously if the chest X-ray is normal. It is better to do a low-dose lung CT. If there is a family history of intestinal cancer and gastric cancer, even if you are only in your thirties, don't wait for routine physical examinations to show problems before going for a gastrointestinal endoscopy. It is safe to do regular screenings in advance according to specialist recommendations.

To put it bluntly, "no abnormality found" in a routine physical examination can only mean that the few tests you have done have not found any problems for the time being. It does not mean that there are no hidden dangers in the whole body. It is the bottom line of health protection, not a universal safe. It is better to add items when it is time to add items, and to follow up when it is time to follow up, than to regret later if there is a big problem.