Ageing is a journey no-one can escape. Fortunately, there are increasing ways in which you can slow down the process. One powerful tool is health screening tests. A screening test is done to spot potential illnesses in people who don't have any symptoms of a disease.
Thanks to advancements in medical technology, we now have a window into the body like never before. These screenings can detect potential health threats such as a localised cancer long before symptoms emerge, which offers a chance for early intervention and full recovery. Medical screenings are now an important preventative health strategy. Direct-to-consumer screening tests have now even become popular as health-conscious gifts.
In a recent editorial, Lancet, however, warns that many of the direct-to-customer screening tests lack real medical value and can do more harm than good. The direct-to-customer industry is booming and capitalises on consumers’ fears of ageing and disease. Companies sell genetic, wellness and biochemical screenings with exaggerated promises of their efficacy. False positives can create unnecessary anxiety, while false negatives can provide false security, especially with cancer screenings. It’s a case of damned if you do and damned if you don’t. Four medical experts weigh in on the value of medical screening tests and what you can do to slow down ageing and live a healthier, longer life.
Dr Maritha van der Walt, Discovery’s chief medical officer, believes in the life-saving potential of evidence-based screening. But it’s crucial that it's the right test at the right time. Over-testing may introduce more risks than rewards. It’s a balancing act. Diagnosing a condition that may never become problematic or an illness with limited treatment options puts patients and doctors in difficult positions. Subsequent procedures could be unnecessary and costly. If an untreatable disease is identified some patients may prefer not to know about it. In such cases discussions between the medical practitioner and the patient are crucial to weigh up the pros and cons. Testing should align with a patient’s goals, resources and the potential downstream risks.
Testing from birth to adolescence
Dr Brenda Witt, a family physician, sees testing as a lifelong journey beginning at birth. Early screenings for inherited conditions that cause vision or hearing loss could prevent future complications if treated early. Throughout life, specific tests target age-relevant health concerns, such as drug or HIV screenings for teens. This could start with a simple questionnaire to gauge if more screening is necessary.
Middle age onwards
Geriatrician Dr India Butler emphasises the importance of regular risk assessments. While not every illness is preventable, basic screenings paired with a healthy lifestyle support both longevity and quality of life. For instance, she recommends that asymptomatic patients should have regular checks for blood pressure, cholesterol and diabetes. Women over 40 should consider mammograms and bone density tests, while men aged 40-45 may benefit from prostrate-specific antigen tests. A colonoscopy around age 45-50 can also be a wise choice, especially with a family history of colon cancer. As people get older these tests have less value in helping them live longer or improving quality of life. Over the age of 70-80 it should be a discussion about the benefits and potential harm with your doctor before testing. Frail people may have other health priorities.
"Many of the direct-to-customer screening tests lack real medical value and can do more harm than good"
When is heart screening advisable?
Professor Eric Klug, a specialist cardiologist and president of the SA Heart Association, notes that when considering public health policy and “mass routine heart screening policies”, heart stress screenings are usually reserved for those with clear risk factors. These screenings could be a simple treadmill effort electrocardiogram (ECG). Over testing of healthy individuals could lead to numerous unnecessary procedures, causing additional stress and costs. However, in certain instances, healthy individuals may request heart screening tests for personal reasons. Asymptomatic men over 40 and women over 50, for example, could benefit from a baseline stress test that could be helpful if future problems arise. Those planning a vigorous exercise programme should also consider testing. Similarly, those in occupations impacting on public safety such as pilots or bus drivers must also be tested. If there are concerns after an ECG test or an individual cannot perform it adequately, further testing is possible. This could include a non-invasive “virtual” coronary angiogram.
Investing in Long-Term Health
Ultimately, Lancet warns customers to look out for screening tests that make claims that sound too good to be true. A holistic approach that includes regular risk assessments, basic appropriate medical screenings and a healthy lifestyle — which includes eating well a healthy weight, exercising, getting enough sleep and being social — is the best way to enjoy a healthier, longer life.
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