Screening for cancer with computed tomography: History repeats itself  in another manifestation of "executive physical  examinations"

doi:10.1136/bmj.326.7404.1458

BMJ 2003;326:1458 (28 June), doi:10.1136/bmj.326.7404.1458

Letter

Screening for cancer with computed tomography

History repeats itself in another manifestation of "executive physical examinations"

The first 150 words of the full text of this article appear below.

EDITOR—For decision analysts Swensen's review of computed tomography screening is both refreshing to see and at the sametime wholly unsurprising.¹ The risks from false positive resultsare made clear even for non-quantitatively oriented clinicians,and questions are raised on other expensive screening proceduresand unsubstantiated recommendations from so called medical centres of excellence.

In the United States countless companies and hospital consortiaoffer "executive physical examinations"—for fees of $3000 (£1785; €2555) and higher—which include cardiacstress tests, scans, measurements of strength and range ofmotion, and sometimes even antibody testing for rheumatologicaldisease, in the guise of detecting the effects of stress onthe immune system. One company, HealthAmerica (now defunct),offered "consumers" (worried, high powered, corporate executives,presumably) "a comprehensive set of diagnostics and a completebaseline study of all the diseases that are going to cut theirlife short" (www.aishealth.com/isyndicate/MDsurf.html#story5).

Even the Mayo, . . . [Full text of this article]

Alan P Zelicoff, senior scientist

Center for National Security and Arms Control, Sandia National Laboratories, Mail Stop 1363, PO Box 589, Albuquerque, NM 87185-5800, USA zalan8587@uswest.net