BMA warns against unnecessary screening tests in private sectorBMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7515.475-b (Published 01 September 2005) Cite this as: BMJ 2005;331:475
Patients may be putting themselves at unnecessary risk—with very little benefit to their health—by opting to undergo scans and genetic tests that are offered to them as part of a screening programme by private sector healthcare organisations.
That is the warning of a briefing paper by the BMA's Board of Science, which fears that many people are not told of the potential risks before undergoing the tests, such as whole body magnetic resonance imaging or the prostate specific antigen test for prostate cancer. It is calling on the government to address the growing problem of unregulated screening that is offered outside the formal NHS screening programmes. An estimated £65m ($117m; €95m) was spent in Britain last year on private screening.
Speaking at the launch of the paper, Steven Laitner, a consultant in public health medicine, said unregulated screening was often provided for profit. “It is often marketed to certain sections of the population but not necessarily those suffering from disease. It is not quality assured.”
Dr Laitner warned that the tests did not necessarily offer any benefit and could run the risk of harm, which patients were not always made fully aware of. A whole body scan carried the equivalent dose of 100 chest radiographs, he said, and increased the risk of a fatal cancer developing by one in every 2000 patients screened.
He also explained that because the tests could be inconclusive and give false positive results patients often needed further, more invasive tests to estabilish the results' accuracy.
Vivienne Nathanson, the BMA's head of science and ethics, also cautioned against genetic testing that could have implications for life insurance polices, not just for the person being tested but for family members too.
Nobody would be given a genetic test in the NHS without extensive counselling, she said. “Inevitably there is a consequence for the family, and we need to be very careful about the way we handle that,” she said.
But the BMA's comments have been criticised by Andrew Vallance-Owen, medical director of the UK's main private healthcare organisation, BUPA. He said BUPA did give patients information about the tests it offers.
“It is very much empowering patients to make their own choices,” he said. He explained that men aged over 50 who were offered the prostate specific antigen test were given two pages of information about the procedure. BUPA did not routinely offer whole body scans, he said, and he admitted that he was also concerned about the growth in that market.
“What the BMA said about population and genetic screening was evidence based, but I don't see any evidence base for the statements that have been made that have been critical of all private screening,” he said.
Population Screening and Genetic Testing is available at http://www.bma.org.uk/