Health Times： These physical examination items are the most unreliable. Don’t be cheated again.

Original title: Many physical examinations are to deal with things! These most unreliable physical examination items, don’t be pitted again!

Why is the annual physical examination, the indicators are "normal", but suddenly cancer is detected? Is it still late when it is found out?

Speaking of physical examination, many people have the following feelings:

1。 "The detection process is not rigorous, and the disease cannot be detected."

2。 "there are many medical examination packages and the fees are chaotic."

3。 "Some medical institutions are like lanterns. After checking for a long time, they will be psychologically comforted."

Yes, even an internal staff member of a large medical examination institution revealed that "medical examination is a matter of ignorance"!

Moreover, the medical examination fee is not a small expense. A slightly comprehensive inspection package will cost three or four thousand yuan, and the price will easily be "over 10,000" by adding several inspections!

Doctor: Many physical examinations are just a matter of coping with things.

Bi Xiaofeng, deputy director of the Department of Cancer Prevention, Cancer Hospital, China Academy of Medical Sciences, said: In fact, physical examination in many units is easy to become a mere formality, and there is no key direction at all, which is a waste of money and can’t help to check diseases, especially many serious diseases. ①

Physical examination refers to the physical examination of normal people. It is meaningful to be accurate, in place and even critical. For example, screening early rectal cancer by anal digital examination is basically the same as drinking water to satisfy hunger, and it has no practical significance. ①

To this end, Xiao Bian specially counted the "most unreliable" medical examination items. If you encounter a medical examination in the future, don’t do it again, it’s a waste of money!

Inventory: the most unreliable physical examination project!

Color Doppler ultrasound examination of prostate

One of many physical examinations is abdominal color Doppler ultrasound, and men over 40 years old often add an extra item called "Qiancai"-prostate color Doppler ultrasound to screen whether they have prostate cancer.

This test can’t detect early prostate cancer, and it doesn’t even have the effect of diagnosis. There is really no way to identify whether it is benign hyperplasia or prostate cancer by color Doppler ultrasound. This can’t be distinguished, because the manifestations of cancer are the same when detected by color Doppler ultrasound. Whether the patient’s nodules are inflammatory or proliferative nodules can’t be distinguished from color Doppler ultrasound or B ultrasound.

[Correct examination method] If you really want to tell whether it is prostate cancer or not, MRI should be the first choice, and the cost is relatively high. An MRI costs a total of one or two thousand yuan, which is completely unnecessary in the ordinary daily physical examination package. When middle-aged and elderly men need to be screened for prostate cancer, the best examination is prostate-specific antigen project, which is what we call "PSA examination". ②

2 blood calcium examination

In the package of general medical examination center, whether it is the package for the elderly or the package for children’s medical examination, there will be an examination called blood calcium examination. Blood calcium test is to measure trace elements by drawing blood to judge whether there is calcium deficiency, especially for children. Many parents are also particularly concerned about this item. In fact, it is completely unreliable.

According to the doctor, trace elements should not be used as a routine physical examination or an item that needs to be examined. Its accuracy is definitely not as high as that of spot check and examination from venous blood. After finding out (there is a problem), it is forbidden to judge whether he is really deficient in zinc, calcium or iron based on such a laboratory test. The calcium in trace elements refers to the whole calcium. When it is really deficient in calcium, it should be deficient in permanent calcium.

As early as five years ago, in 2013, the former General Office of the National Health and Family Planning Commission issued a notice on the clinical detection of trace elements in children: the detection of trace elements should not be used as a routine physical examination item!

It is also emphasized that medical institutions at all levels should not carry out trace element testing for children unless it is necessary for diagnosis and treatment. Trace element detection should not be taken as a general survey item such as physical examination, especially for infants under 6 months. ③

That is to say, it is illegal to test trace elements during general physical examination and medical treatment! It is clearly stated in the document of the National Health and Family Planning Commission that medical institutions that carry out trace element testing in violation of regulations should be dealt with according to the law!

It is even more nonsense to check blood calcium by drawing blood. This kind of inspection is mostly for the purpose of re-checking and selling calcium tablets to you.

3 cervical curettage screening

In the packages of many medical institutions, there will be an examination for women in their 30 s and 40 s called cervical curettage screening. I often tell you that this test is for cervical cancer.

However, the doctor said that the average satisfaction rate of cervical smear sampling is only 60%, which means that 40% of the inspection samples are unreliable, so the pathologist can’t be blamed for missing diagnosis. Therefore, this inspection must not be done, even if it is done, it will not be found!

[Correct examination method] The most recommended item for screening cervical cancer is ——TCT. The upgrading of technology has improved the sampling satisfaction to over 95%, and those suspicious cancer cells will be difficult to hide! Who needs special attention: married, have found cervical abnormalities, have not checked TCT for three years, and have reproductive tract symptoms. ②

4 creatinine/urea nitrogen check

Generally, in the urine biochemical examination, some medical institutions often recommend you to add a "creatinine/urea nitrogen examination" and tell you that this examination is to check "kidney function".

According to the doctor, even if you lose half of your renal function, you can still survive, and creatinine/urea nitrogen may still be normal. Real kidney damage is often recessive and chronic, and the early damage is not corrected. When there are symptoms or creatinine/urea nitrogen exceeds the standard, you can’t go back! In other words, even if the "creatinine/urea nitrogen test" shows that you have a problem, it will be late!

[Correct examination method] The correct examination to check whether the renal function is normal should be urinary microalbumin-as long as there is a little glomerular damage, albumin may "leak" into the urine, and microalbumin can be accurately detected, so the early renal damage can’t be hidden. It is better to reduce the error caused by urine concentration by detecting the ratio of microalbumin to creatinine in urine, so it is called early renal function screening (ACR).

5 cervical lateral radiograph examination

As we all know, many medical institutions will add a cervical lateral film examination to the medical examination package to help you check whether there is cervical spondylosis.

However, the lateral radiograph of cervical spine can only look at whether there is any abnormality in curvature, and occasionally disc herniation can be found, and a "degeneration" that is meaningless is reported; The dislocation of cervical spine is not only anteroposterior, but also left and right, rotation and other angles, and the influence on cerebral blood supply and nerve root compression needs to be considered. The most important thing is that cervical radiographs not only have little effect, but also inevitably radiate to the most delicate and important organ of the human body-thyroid! You should know how common thyroid problems are.

[Correct examination method] The correct examination should be to go to the hospital to check the cervical MRI-nuclear magnetic resonance can reconstruct the images of cervical vertebrae and intervertebral discs in three dimensions, and there is no radiation concern at all. If combined with the physiological examination of cervical vertebra, it can comprehensively detect the early joint dislocation and dysfunction of cervical vertebra, and help to directly guide rehabilitation.

6 fasting blood glucose screening for diabetes

Many medical institutions will tell you in advance that you should never eat before the medical examination, because blood is drawn to check your blood sugar and check whether you have diabetes.

According to authoritative research, fasting blood glucose screening will miss nearly half of diabetes and more than 70% of pre-diabetes, and at least half of them have disorder of blood glucose metabolism (or diabetes trend), so it can be said that fasting blood glucose screening for diabetes is the most unreliable physical examination item!

[Correct examination method] The correct examination should be to check glycosylated hemoglobin, which can reflect the average blood sugar level for three months and greatly reduce the missed diagnosis caused by fasting blood sugar alone; Early diabetes screening is recommended, which can detect the physiological disorder of blood sugar/insulin at an early stage, and it is the most suitable early warning method for diabetes in general survey without blood drawing and needle puncture.

The first few items of physical examination generally have the measurement of "height and weight". Many people have finished the examination, and often the results appear last time-obesity and overweight.

In fact, judging whether you are obese by your body weight is not so accurate. This is because the formula for judging obesity is the conversion formula of BMI.

Body mass index formula (BMI)= weight (kg) height 2 (m)

However, there are many "hidden fat people" who are not fat but have high fat content; There are also super-fit people, who weigh off the charts but have a perfect figure, but of course they are not obese. ②

[Correct inspection method] Experts remind that the standard of body composition analysis-whether it is obesity is definitely the body fat rate, not the height-weight ratio. Therefore, we can’t fully believe the "obesity and overweight" in the physical examination report.

No gastric cancer can be found in 8 laboratory indexes.

Laboratory indicators include hematocrit, hemoglobin, fecal occult blood, gastric juice and many other items, which are often used to indicate the health of the stomach in physical examination, but in fact, gastric cancer can not be detected.

It’s ok to use laboratory test indexes in the primary screening of gastric diseases, but if we use these indexes to screen gastric cancer, it’s a bit overwhelming, because their accuracy is still not up to the requirements.

[Correct examination method] Experts suggest that gastroscopy is the most standard and accurate, and it is the first choice for screening and diagnosing gastric cancer. However, gastroscopy is relatively expensive and more painful, and it is an invasive examination. Therefore, if the result of the first gastroscopy is benign, it can be done every five years. However, if the physical examination results show that there are patients with gastric dysplasia (such as inflammation), atrophy, gastric ulcer or family history of gastric cancer, besides treating these diseases, the interval of physical examination is preferably 2~3 years.

Finally, after reading this article, pass it on to your family.

Don’t waste money on the next physical examination!

References:

① Beijing Evening News "Physical examination indicators are" normal "but we have cancer soon. Have we encountered a" fake physical examination "? "Little doctor comics" Most physical examinations are handled, and serious illnesses can’t be found at all! 》

② List of "The Most Unreliable Physical Examination Items Confirmed by Doctors" by Central Broadcasting Network: Difficult to diagnose.

③ The website of the former National Health and Family Planning Commission