The significance of disease screening

With the lowest cost in terms of health, economy and time, the risk of serious illness is stopped in the bud, while leaving enough room for every ordinary person to proactively choose their health instead of passively accepting the disease when it breaks out.

Last year, I helped with the voluntary registration for two cancer screenings at the community health service center in the neighborhood. I met 52-year-old Aunt Zhang. She usually dances in the square every day and can climb the fourth floor without losing breath. If the community had not repeatedly called for free screening and distributed a small bag of eggs as welfare, she would have felt that she was not sick and did not need to make this trip. As a result, TCT detected high-grade lesions, and further biopsy showed early-stage cervical cancer. Later, an outpatient conization operation was performed and the disease was resolved. She didn’t even need chemotherapy. Now she is still leading the team to dance her "Little Apple". I later talked to the gynecologist in charge of the screening, and she sighed and said that last year there was an aunt who was less than 60 years old. The community called her three times but she didn't think it was troublesome. She waited until contact bleeding occurred before she came back for a check. It was already in the advanced stage. She spent hundreds of thousands and suffered serious crimes. Now she can't even go out for a walk.

Of course, not everyone thinks that screening is a good thing. I have seen many people say before that "they were not sick at first, but they were scared to get sick when they found out some minor problems." There is even a saying that "excessive screening can harm the body." This is really not groundless. I had dinner with Director Li from the physical examination center of a tertiary hospital. He said that there are two extremes now. One is that they don't believe in screening at all and feel that "it's better not to check if it is detected and cured." For example, the U.S. Preventive Services Task Force adjusted screening guidelines a few years ago and raised the recommended age for prostate cancer PSA screening for the general population from 50 to 55 years old. This is because many low-risk groups previously had false positives and had to undergo unnecessary puncture biopsies instead. They suffered in vain and were anxious, and even experienced complications such as infection after puncture.

If you really go to the clinic and ask around, you will know that the treatment costs and prognosis of many diseases in the early and late stages are not even close to half a star. Take lung cancer as an example. The 5-year survival rate for late-stage lung cancer is less than 10%. If ground-glass nodules are screened through low-dose spiral CT in the early stage, minimally invasive surgery will hardly affect lifespan after removal, and the total cost is only 10,000 to 20,000. For advanced lung cancer, targeted drugs alone may cost several thousand a month. They also have to bear the side effects of radiotherapy and chemotherapy, and the survival period is still short. There is also diabetes. If you are screened for abnormal glucose tolerance in the early stage, you don’t need to take medicine. As long as you keep your mouth open and move your legs to control your weight, you will most likely be able to return to normal. Once the typical symptoms of three more and one less appear, and you are diagnosed with diabetes, you have to take medicine and insulin for life. Later, you may develop complications such as fundus lesions and diabetic foot, and your quality of life will be very poor.

I had a baby two years ago. I was 29 years old. My workplace provides free physical examinations every year. He ran away every time, saying that he was young and strong and had nothing wrong with him. However, last year he suddenly suffered from stomachache and black stools.

In fact, disease screening is a bit like our annual car inspection. You can't wait until the car breaks down on the road or the engine burns out and then repairs it. The money spent and time wasted at that time is much more than the annual inspection. But you don't need to dismantle the car every week to inspect it, which will wear out all the good parts. The same principle applies to screening. It is not that more is better or more expensive is better. It has to be adapted to your own situation: those with a family history of lung cancer and smokers all year round need to do low-dose spiral CT every year at the age of 40. Ordinary people without high-risk factors can do it again at 50. ； Those with a history of hepatitis B and hepatitis C should have alpha-fetoprotein and liver ultrasound checked regularly. Ordinary healthy people do not need to check tumor markers every year. Those transient increases are most likely just caused by staying up late and being inflamed, but will scare themselves for months.

To be honest, many people now have misunderstandings about screening. They either regard it as a "life-saving miracle drug" and think that it can detect anything, or they regard it as a scourge and think that if it is detected, it will be a problem. But in fact, its meaning is never to give you a death sentence of "whether you are sick or not", but to remind you: there are some minor problems in your body that need attention now, and you still have a lot of room for adjustment. You don't have to wait for the disease to come to your door before panicking. After all, when it comes to health, the initiative in your own hands is the most valuable.