Many patients are familiar with the need to keep a regular — often annual — check on certain aspects of their body’s biochemistry if they are on particular treatments or suffering from certain conditions. For example, it is important to monitor kidney function in individuals with high blood pressure or to keep an eye on average glucose levels for people suffering from diabetes.
But over recent years two other benefits of yearly health checks — aside from simply monitoring — are being recognised: they can encourage people to adopt a healthier lifestyle and they assist in the earlier diagnosis of cancer. The ideal annual health check (either through the NHS or done privately) should therefore be designed with these objectives in mind.
Knowing your numbers is certainly a powerful motivator to improve your health. As a GP I have often witnessed the benefits of working with patients to track their liver tests in encouraging them to moderate their alcohol consumption. For others knowing their average glucose levels using the HbA1C test (an indicator of their future risks for developing type-2 diabetes) seems to be a particularly powerful motivator to lose weight. On my own part, being aware of my cholesterol levels and seeing how this could be affected by lifestyle has kept me going to the gym for the last five years.
Diagnosing cancer at an early and curable stage is what all of us with an interest in screening would love to achieve. Unfortunately the traditional approach to screening focused on single health checks fails to recognise that many cancers evolve gradually over a period of time with quite subtle changes occurring in the body much earlier. For example, although anaemia can be a sign of bowel or stomach cancer, research from Denmark and Sweden has shown that small alterations in a person’s blood count often begin to happen two to three years before the cancer is first diagnosed. The laboratory would not usually alert GPs to any such gradual changes as they are focused on flagging up significantly abnormal individual results rather than alterations from a person’s previous values.
Annual monitoring of men’s PSA levels and women’s CA125 levels — markers of prostate cancer and ovarian cancer — are also now seen as an important tool in improving diagnosis and survival from these conditions. Two large research projects from the United States and the UK have now provided compelling evidence that we should pay as much attention to the changes in these markers as we currently do to their absolute values.
For example, in my own practice I recently encountered a man who had undergone PSA testing and had been informed that his result was in the ‘normal range’. Fortunately, this individual had had the same test undertaken by the same laboratory exactly one year previously. When I compared the two results I noted that the PSA level had actually doubled over the year and I referred him on for specialist assessment. He is now being treated for early prostate cancer.