Photo by Indeed/Getty Images
In her 30-year career, Rosanne M. Leipzig, M.D., Ph.D., says, she's never seen patients so anxious about their health. They want to be X-rayed, scanned, and tested, even if they're feeling fine. They want to be checked for diseases they've heard about only on television or the Web. "We've become hyperaware of our health," notes Leipzig, a professor and geriatrician at Mount Sinai School of Medicine in New York City. What with 24/7 health news, relentless medical advertising, and the reality that "everybody has heard about somebody who's had something," it's becoming more difficult for doctors to calm often unfounded fears of impending illness.
Giving patients a reassuring test or two once seemed harmless enough, says Leipzig. As a member of the U.S. Preventive Services Task Force (USPSTF), an independent panel of medical experts who review the effectiveness of screening tests, she knows many of these tests can prevent disease and save lives. Bone-density scans detect the presence of osteoporosis and can signal the need for protection against potentially life-threatening fractures. Mammograms can catch abnormalities that may point to breast cancer. Blood tests give doctors a quick heads-up about everything from bacterial infections to diabetes.
But, says Leipzig, with booming patient demand for all manner of tests—and a $100 billion diagnostic-imaging industry helping to drive that demand with CT scans, MRIs, and X-rays—physicians are walking a fine line between addressing real patient concerns and creating new problems.
Take CT scans, those three-dimensional X-rays that can "see" through bones, muscles, and organs. Doctors now order an estimated 68 million each year—triple the number in 1995. Yet a recent study in The New England Journal of Medicine found that a single stomach or spine CT scan exposes patients to a radiation dose equal to 100 regular X-rays. Such imaging, researchers say, may be responsible for up to 2 percent of cancer cases over the next 20 to 30 years. CT scans can also produce false positives: one 2004 study found that 43 percent of patients received at least one false-positive result after undergoing scans for prostate or ovarian, colorectal, and lung cancer, when no symptoms were present. And those results can lead to other, more invasive tests, such as biopsies—which can be painful and bring on infection and other problems—and risky surgeries.
The problems are leading many doctors to question which tests are beneficial and under what circumstances. And they're setting off some highly charged debates in the medical community and beyond.
Click to read more of the AARP Magazine feature
Copyright 1995—2009, AARP.
May 7, 2009
USA: Medical Screenings You Can't Live Without
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WASHINGTON DC / AARP The Magazine / Health / May 7, 2009
By Dawn Fallik, May & June 2009
Which health tests you can skip—and which can save your life
Photo by Indeed/Getty Images
In her 30-year career, Rosanne M. Leipzig, M.D., Ph.D., says, she's never seen patients so anxious about their health. They want to be X-rayed, scanned, and tested, even if they're feeling fine. They want to be checked for diseases they've heard about only on television or the Web. "We've become hyperaware of our health," notes Leipzig, a professor and geriatrician at Mount Sinai School of Medicine in New York City. What with 24/7 health news, relentless medical advertising, and the reality that "everybody has heard about somebody who's had something," it's becoming more difficult for doctors to calm often unfounded fears of impending illness.
Giving patients a reassuring test or two once seemed harmless enough, says Leipzig. As a member of the U.S. Preventive Services Task Force (USPSTF), an independent panel of medical experts who review the effectiveness of screening tests, she knows many of these tests can prevent disease and save lives. Bone-density scans detect the presence of osteoporosis and can signal the need for protection against potentially life-threatening fractures. Mammograms can catch abnormalities that may point to breast cancer. Blood tests give doctors a quick heads-up about everything from bacterial infections to diabetes.
But, says Leipzig, with booming patient demand for all manner of tests—and a $100 billion diagnostic-imaging industry helping to drive that demand with CT scans, MRIs, and X-rays—physicians are walking a fine line between addressing real patient concerns and creating new problems.
Take CT scans, those three-dimensional X-rays that can "see" through bones, muscles, and organs. Doctors now order an estimated 68 million each year—triple the number in 1995. Yet a recent study in The New England Journal of Medicine found that a single stomach or spine CT scan exposes patients to a radiation dose equal to 100 regular X-rays. Such imaging, researchers say, may be responsible for up to 2 percent of cancer cases over the next 20 to 30 years. CT scans can also produce false positives: one 2004 study found that 43 percent of patients received at least one false-positive result after undergoing scans for prostate or ovarian, colorectal, and lung cancer, when no symptoms were present. And those results can lead to other, more invasive tests, such as biopsies—which can be painful and bring on infection and other problems—and risky surgeries.
The problems are leading many doctors to question which tests are beneficial and under what circumstances. And they're setting off some highly charged debates in the medical community and beyond.
Click to read more of the AARP Magazine feature
Copyright 1995—2009, AARP.
Photo by Indeed/Getty Images
In her 30-year career, Rosanne M. Leipzig, M.D., Ph.D., says, she's never seen patients so anxious about their health. They want to be X-rayed, scanned, and tested, even if they're feeling fine. They want to be checked for diseases they've heard about only on television or the Web. "We've become hyperaware of our health," notes Leipzig, a professor and geriatrician at Mount Sinai School of Medicine in New York City. What with 24/7 health news, relentless medical advertising, and the reality that "everybody has heard about somebody who's had something," it's becoming more difficult for doctors to calm often unfounded fears of impending illness.
Giving patients a reassuring test or two once seemed harmless enough, says Leipzig. As a member of the U.S. Preventive Services Task Force (USPSTF), an independent panel of medical experts who review the effectiveness of screening tests, she knows many of these tests can prevent disease and save lives. Bone-density scans detect the presence of osteoporosis and can signal the need for protection against potentially life-threatening fractures. Mammograms can catch abnormalities that may point to breast cancer. Blood tests give doctors a quick heads-up about everything from bacterial infections to diabetes.
But, says Leipzig, with booming patient demand for all manner of tests—and a $100 billion diagnostic-imaging industry helping to drive that demand with CT scans, MRIs, and X-rays—physicians are walking a fine line between addressing real patient concerns and creating new problems.
Take CT scans, those three-dimensional X-rays that can "see" through bones, muscles, and organs. Doctors now order an estimated 68 million each year—triple the number in 1995. Yet a recent study in The New England Journal of Medicine found that a single stomach or spine CT scan exposes patients to a radiation dose equal to 100 regular X-rays. Such imaging, researchers say, may be responsible for up to 2 percent of cancer cases over the next 20 to 30 years. CT scans can also produce false positives: one 2004 study found that 43 percent of patients received at least one false-positive result after undergoing scans for prostate or ovarian, colorectal, and lung cancer, when no symptoms were present. And those results can lead to other, more invasive tests, such as biopsies—which can be painful and bring on infection and other problems—and risky surgeries.
The problems are leading many doctors to question which tests are beneficial and under what circumstances. And they're setting off some highly charged debates in the medical community and beyond.
Click to read more of the AARP Magazine feature
Copyright 1995—2009, AARP.
