Review: Routine Physicals Don't Cut Morbidity Mortality
One trial found that health checks linked to increase in number of new diagnoses
WEDNESDAY, Nov. 21 (HealthDay News) -- Routine health exams do not reduce overall, cardiovascular, or cancer-related morbidity or mortality, according to a review published online Nov. 20 in BMJ.
Lasse T. Krogsbøll, M.D., from Rigshospitalet in Copenhagen, Denmark, and colleagues conducted a systematic literature review and meta-analysis of randomized trials to quantify the benefits and harms of general health checks in adults. Randomized trials comparing routine health checks with no health exams in adult populations unselected for disease or risk factors were included, 14 of which had available outcome data (182,880 participants).
The researchers found that, based on data from nine trials (11,940 deaths), the risk ratio [RR] for total mortality was 0.99 (95 percent confidence interval [CI], 0.95 to 1.03). Based on data from eight trails, the RR for cardiovascular mortality (4,567 deaths) was 1.03 (95 percent CI, 0.91 to 1.17), and for cancer mortality (3,663 deaths) was 1.01 (95 percent CI, 0.92 to 1.12). These findings were not altered by subgroup and sensitivity analyses. Based on data from some trials, health checks did not provide a benefit on morbidity, hospitalization, disability, worry, additional physician visits, or absence from work. There was an increased prevalence of hypertension and hypercholesterolemia in one trial and two of four trials found an increased use of antihypertensives. Over six years, health checks led to a 20 percent increase in the total number of new diagnoses per participant in one trial.
"Our results do not support the use of general health checks aimed at a general adult population outside the context of randomized trials," the authors conclude.