In recent years, many people go for health screening in the hope that hidden diseases can be detected early.
Many health check packages available in the market are often promoted by means of telephone calls, mailed leaflets, newspaper advertisements or group-buying websites. A wide variety of health check plans, ranging from the "standard" and "budget" packages which include blood tests, urine tests, electrocardiogram etc to the "premium" and "deluxe" plans comprising tumor marker tests and medical imaging such as X-ray, ultrasound and computerized tomography scanning (CT scan).
In a study on more than a dozen health check packages in the market, the Consumer Council revealed that the price of these packages varies from HK$188 to HK$7,000, not all of them come with a follow-up medical consultation or advice from a healthcare professional.
Some of these packages list out a large number of test items, making them look particularly good value for money: in one case a single test of complete blood count is split into 10 sub-items, but it is taken as one single item in other packages; and in another case, a HK$188 package is promoted as having 47 items of laboratory test items.
The survey also uncovered that some of the test items in the health package are unnecessary, simply a waste of money for people without specific symptoms.
Examples could be found in a blood test, which includes screening for red blood cell count, packed cell volume or test on rheumatic diseases. They are useless in the diagnosis of patients without anaemia or relevant symptoms of rheumatic disease.
Neither does the test of blood calcium content help diagnose osteoporosis as the calcium level in blood is not directly related to bone density.
Results of the tumor marker tests, which are included in most of these health check packages for screening of cancer, could be affected by many factors. Consumers are advised to consult medical practitioners to obtain appropriate health evaluation based on their clinical judgement.
The measurement of tumor marker, which is generally used to assist the diagnosis of cancer and to monitor the recovery process from cancer, is not an appropriate screening tool for cancer diseases. As a matter of fact, in the early stage of cancer, the tumor marker level may not be higher than normal, while some benign diseases may give rise to a high tumor marker level. Another example is the screening for prostate cancer, approximately 3 out of 4 men with a high PSA (prostate specific antigen) level do not have prostate cancer (false positive result).
Exposing oneself to unnecessary tests not only wastes time and money, it also poses health risks.
The radiation in an X-ray test or a CT scan can be carcinogenic. It can lead to infertility and genetic mutation, the latter may cause defect in the foetus. Consumers are advised to seek the advice of medical professional before enrolling in such tests.
According to the Hong Kong Medical Association, there is insufficient evidence to support that the following tests included in some health check packages are useful in detecting hidden disease: complete blood count or blood test, erythrocyte sedimentation rate, rheumatoid factor, liver function screening, renal function screening, thyroxine, uric acid, urine routine screening, stool test (except "stool occult blood test" which may be useful for screening of colon cancer) or lung function test.
Nonetheless, medical experts recommend people to undergo regular screening items that have been proven effective in the detection and prevention of certain diseases, such as cervical smear test for cervical cancer and measurement of blood pressure for hypertension and heart disease.
The Consumer Council has received a total of 28 cases regarding health check services from 2009 to July 2011, most of them are related to sales practices and service quality.
When considering a health check package, the Council advises consumers not to rely only on the suggestions of the health check service providers, or look for the number of items included in a plan - the more does not necessarily mean the better.
Items in a health check test should be suggested by medical practitioners, who will make reference to one's medical background including age, medical history, lifestyle and family history etc. In addition, they will also review the laboratory test results and their clinical judgement to perform meaningful analysis and risk evaluation.
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