General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis

Are general health checkups ineffective for reducing mortality?

20 January 2013

Recently, Krogsboll and colleagues conducted systematic review and meta-analysis on the efficiency of general health checkups [1]. Their review presented the lack of the effect of health checkups on morbidity and mortality based on randomized controlled trials. The main outcomes were total mortality, cardiovascular mortality and cancer mortality. The morbidity, hospitalization, disability, worry, physician visits, or absence from works were also assessed with no significant advantage of attending general health checkups.

But the uselessness of general health checkups in their paper should be handled with caution. The reviewed studies adopted some different procedures to detect health status in the past four decades, and there have been many changes in medical screening approach in this long period of time [2]. The medical costs of further diagnostic testing and follow-up costs thereafter is important for evaluating the effectiveness of general health checkups, and multi-dimensional approach is indispensable for the cost-effectiveness (benefit) analysis.

There is a gap among perception, awareness and attitude for health outcomes after attending general health checkups. Although the subjects are aware of the link between hypertension and stroke, they do not fully appreciate the consequences of uncontrolled hypertension [3]. Perception of health problems by attending the general health checkups does not always lead to the awareness or attitude for the recovery of health. Desirable healthy activity by the modification of their lifestyles is also required to make lowering of morbidity or mortality. On this point, health education is a very important activity to improve the levels of awareness and attitude for health outcomes. Existence of several steps from general health checkups to morbidity or mortality should be considered before making their conclusion.

REFERENCES
1. Krogsboll LT, Jorgensen KJ, Gronhoj Larsen C, Gotzsche PC. General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis. BMJ 2012;345:e7191.
2. Prochazka AV, Caverly T. General Health Checks in Adults for Reducing Morbidity and Mortality From Disease: Summary Review of Primary Findings and Conclusions. JAMA Intern Med 2013 doi: 10.1001/jamainterned.2013.3187.
3. Volpe M, Dedhiya SD. Physicians, patients, and public knowledge and perception regarding hypertension and stroke: a review of survey studies. Curr Med Res Opin 2006;22(7):1319-1330.

Competing interests: None declared

Tomoyuki Kawada, Professor

Niipon Medical School, Sendagi, Bunkyo-ku, Japan

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