by Marilynn Preston
If you want to live a longer, healthier life, be aware of this: According to top doctors, most of the medical tests you think you need to diagnose and prevent disease — yearly cardiograms, exercise stress tests, routine EKGs, annual Pap tests, MRIs for lower-back pain — don’t prevent anything and aren’t necessary.
Surprised, Dear Reader? It gets better. Not only are many of these popular tests unnecessary; they should actually be avoided. The frequent false positives do more harm than good, many doctors have concluded, and often lead to a downward spiral of invasive follow-up procedures, drugs and surgeries.
And still, medical overtesting continues to be a competitive sport in this country. Rosemary Gibson, co-author of an eye-opening book called “The Treatment Trap,” estimates that $225 billion a year is wasted on tests, scans and other procedures that are good for the annual incomes of doctors and hospitals, but confusing and harmful for patients, who are at their mercy.
It’s time to wake up and just say “no” the next time your doctor schedules you for a bone-density scan, and you’re a woman younger than 65.
That’s just one of the “10 Tests to Avoid,” as reported by Elizabeth Agnvall in a recent AARP Bulletin, not exactly a hotbed of radical thinking. Agnvall’s list is based on research conducted recently by the American Board of Internal Medicine Foundation, which asked more than 50 medical societies — including oncologists, cardiologists, family doctors — to name the tests and treatments that were often performed but rarely helpful
Here’s an abbreviated version of her much more detailed list. These aren’t commands, but I suggest you use them for your own research, based on your risk factors and your current health. Let your home schooling inspire a heart-to-heart with your medical team:
1. Avoid nuclear stress tests and other imaging tests after heart procedures. “More testing is not necessarily better,” says Dr. William Zoghbi, immediate past president of the American College of Cardiology Foundation. He doesn’t like the excess of radiation exposure either. It’s more productive for the patient and doctor to focus on what we know helps when it comes to nurturing a healthy heart: managing weight, increasing exercise, controlling blood pressure.
2. Avoid yearly electrocardiograms and exercise stress tests. Too many people with no symptoms and low risk of heart disease wind up having tests that produce false positives, leading to unnecessary heart catheterization and stents.
3. Avoid blood tests to measure PSA to screen for prostate cancer. There’s “extremely convincing evidence” that in men with no symptoms and usual risk, the PSA test causes more harm than benefit, says Dr. Reid Blackwelder, president of the American Academy of Family Physicians.
4. Avoid PET scans to diagnose Alzheimer’s disease. The PET scan can pick up the presence of beta-amyloid protein found in brains of people with Alzheimer’s. The problem is: PET scans in older people consistently find the protein in those whose memories are just fine.
5. Avoid X-rays, CT scans and MRIs for lower-back pain. Most back pain goes away in a month, and imaging tests lead to expensive procedures that don’t help with recovery. Older people with no back pain can have terrible-looking scans. Warning: If you do have back pain, and your legs feel weak or numb, you have a history of cancer, or you’ve had a recent infection, see your doctor.
6. Avoid a yearly Pap test. A yearly visit to an OB-GYN is still commonly recommended, but women at average risk only need a Pap smear every three years.
7. Avoid a bone-density scan for women before age 65 and men before age 70. Many experts argue that for women ages 50 to 65 with osteopenia — mild bone loss — testing and drugs may be a waste. And many popular bone-strengthening medications can have awful side effects.
8. Avoid follow-up ultrasounds for small ovarian cysts. “The likelihood of these small simple cysts ever becoming cancer is exceedingly low,” says Dr. Deborah Levine, Harvard professor of radiology and expert on ultrasounds.
9. Avoid colonoscopies after age 75, if your previous colonoscopies have always been normal.
10. Avoid a yearly physical. Annual checkups don’t keep you healthy (unless your doctor doubles as your yoga teacher).
Marilynn Preston — healthy lifestyle coach and Emmy-winning producer — is the creator of Energy Express, the longest-running syndicated fitness column in the country. Visit her website, marilynnpreston.com.