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Are Annual Health Checkups Really Necessary?

Jiayu WU, Internal Medicine Physician

Health management is an increasingly important issue for people and most employers now offer annual health checkups, or physical examinations, for employees as part of their overall wellness program. Some people think the examinations are troublesome and choose to ignore them or skip them entirely. Many people wonder, is this physical checkup really necessary? What items should be included in the checkups? What should I do if there are abnormal results? Dr. Celine Wu is our resident expert in the Health Management Center, and she will answer these questions and more for you here.

Q: Should we have health checkups every year?

A: I saw two extremely different kinds of patients in my work. One type is prone to ignore or avoid health checkups as it’s either too much trouble or they are afraid to face potential abnormal results. The other type of patients are those so anxious that they frequently visit hospitals requesting excessive checkup items. In reality I would say, yes, annual health checkups are definitely an indispensable tool to monitor your health conditions and also screen for risks as early as possible. Health checkups should always be reviewed with a doctor face-to-face, especially if there are any abnormal results, so any questions and follow up actions can be addressed.

Q: What items should be included in regular health checkups?

A: A regular health checkup typically includes blood tests and other supplemental examinations. A typical routine blood test should include a complete blood count to calculate the red and white blood cells as well as measure the hemoglobin levels and other blood components. With blood tests, we can also check the liver function and renal function, as well as screen for biomarkers associated with cancers. For elderly people, we would also recommend tests for factors related to rheumatism.

Additionally, other assessments such as electrocardiograms and imaging should be included. With electrocardiograms we can check the heart rate and heart rhythm. For imaging, such as chest CT scan, are mainly for screening for cancerous tissues in the liver, breast, and lung.

There are also exams specific for males and females respectively. For example, we would recommend transrectal prostate ultrasound for men. And for women a pap smear, HPV test, and a mammogram are standard.

The risk of cardiovascular disease and cancers increase with age, so we will focus more on risk factor indicators such as blood lipid panel. We will also recommend transthoracic echocardiography (TTE) and a treadmill exercise test (TET) according to individual needs.

Q: What should people do if they find abnormal results in their medical examination reports?

A: People should always review the full report with the help of their healthcare provider, instead of simply reading it by themselves. Some abnormal test results might appear dreadful but are actually not as serious as they appear. On the other hand, some crucial indicators can be easily overlooked. Doctors will generally focus on the trend of the test results over the past few years, instead of just the figures in a single test. For example, the normal white blood cell (WBC) count is between 4 and 10*109/L. If a man’s WBC count is 9*109/L, he may see think it’s normal. But if it was 5*109/L in his test last year, we would see this change as much more significant. Therefore, I always tell people to have their health checkups regularly and ask their healthcare providers to review the reports with the patient.

Q: In what situations would you advise people to come back for follow-up tests?

A: High blood pressure, high blood lipid levels, and high blood sugar levels are indicators for chronic disease. In these situations I will suggest people to go to the hospital for further examination and treatment as needed.

For cancer screening, sometimes tumor markers are sensitive but not specific enough, so we would recommend people with such abnormalities to arrange a follow-up visit. I would focus more on abnormal imaging results such as ultrasound and CT scans, for example if there are any nodule found. We would not arbitrarily presume nodules are malignant, but I would arrange regular follow-ups to monitor any changes or growth of the nodules in the months and years to come.

Q: What can we do to help manage and monitor our health?

A: People nowadays live a fast-paced life which can lead to a series of chronic conditions. High work pressure may contribute to hypertension and chronic gastropathy. Excessive fatigue can be revealed by abnormal white blood cell counts.

While reviewing checkup reports with my patients, I find that many abnormal results are a reflection of unhealthy living habits. For example, people who habitually stay up late may have an abnormally impaired liver function. And people suffering from urinary infections tend to spend numerous hours of prolonged inactivity in the chair.

As we age, our base metabolic rate is reduced. This will increase the accumulation of fat, causing obesity, especially if there is insufficient diet control or physical exercise. People with obesity are more likely to develop a host of potentially serious health problems including sleep apnea, osteoarthropathy, strokes, and certain cancers.

These are my suggestions for a healthy lifestyle:

  • Maintain a healthy diet. Consume adequate amounts of vegetables, fruits, whole wheat, and white meat (such as fish and chicken). Avoid too much red meat such as beef or lamb, and limit sugar intake.
  • Ensure good sleep quality. You should have adequate quality sleep. Do not stay up late in the night. If you’re concerned that your sleep quality is subpar, some simple strategies may help. For instance, make sure that your bedroom is entirely dark (use blinds to block outside light) and the temperature is cool. Other lifestyle changes such as limiting alcohol consumption and getting more exercise are shown to improve overall sleep quality.
  • Some physical activity is always better than none. Move more and sit less throughout the day. Research shows adults who sit less and do any amount of moderate-to-vigorous intensity physical activity gain many health benefits.
  • Have regular health checkups. Review the results with your healthcare provider and follow their advice. Do not ignore the seemingly unremarkable results and be careful not to undergo excessive medical treatments.

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