The new religion: screening at your parish churchBMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b1940 (Published 20 May 2009) Cite this as: BMJ 2009;338:b1940
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My elderly relative recently received an invitation on a letterhead entitled ‘Life Line Screening: the Power of Prevention’ for precisely the same package of tests referred to in Charles Warlow's article. She had been made extremely anxious by the letter and thought she would go along “just to be on the safe side”. The letter had a postscript “Your friends and family are welcome to have these tests even if they haven’t received a letter. Please tell a friend or a loved one – you may just save a life”.
Eighteen months ago a patient of mine was invited for ‘thermographic breast screening’ at her private gym. Having recently lost a relative to breast cancer she turned up and paid £75. She had a heat-sensitive probe passed across her torso and received a report two weeks later, reassuring her that all was normal but advising her to reattend annually for the same test. She told me “I think I’ve been had”, and gave consent for me to use her anonymised details to pursue the perpetrators of the scam.
Thermography is an unreliable screening test for breast cancer because of the high proportion of false negative results (i.e. many women with undiagnosed cancer will be falsely reassured). My patient had been “screened” by a Registered General Nurse who had promised her that her thermographic scans would be reported by “qualified doctors”. The doctors in question were based in the USA. I telephoned the Healthcare Commission and was told that because the doctors were not UK- based, they had no powers of governance over the organisation. They advised me to report the nurse (who was also the company’s managing director) to the Nursing and Midwifery Council, which I did. By the time my complaint was heard the nurse in question had already been struck off the nursing register for an unrelated offence (theft of prescription drugs).
Like the thermographic screening test, the Life Line stroke screening package is presented as “fast”, “painless”, and “non- invasive”. The results of the tests, the letter promises, will be assessed by a “fully accredited consultant”. However, the only medically qualified individual mentioned on the organisation’s website is based in the USA. When I phoned the Lifeline help line I was assured that my results would be looked at by British consultants but the adviser was unable to tell me who these individuals were.
Life Line Screening’s website also contains a number of testimonials thanking the company for detecting conditions that are now being followed up by the person’s GP. One who tested negative added “I should also like to say that the whole screening process was a very pleasant experience, carried out quietly and efficiently and with understanding and with no extra waiting about. I think the whole thing is an excellent idea and would like to thank all concerned.”
What the testimonials miss, and what the propaganda fails to acknowledge, is that screening tests worth having are often slow, undignified, painful, messy, and inconvenient – and that conversely, a package that avoids intimate orifices, body fluids, exposure to radiation or other hassles may be little better at confirming or excluding life-threatening conditions than spitting in the wind.
Competing interests: No competing interests