It seems that in fairy tales and bedtime stories something is always too big or too small.
No one's feet were the right size for the glass slipper but Cinderella's. When Alice was in Wonderland, she found herself growing and shrinking to inconvenient sizes. Goldilocks found most of the porridge too hot or cold and the chairs too big or small.
We run into the same thing here in the real world, including the health care field. Namely, health care providers often screen people for diseases too often or not often enough. And just as a glass slipper won't do you any good if it's cutting into your foot or falling off, screenings can cause problems if they're not done on the best schedule.
Several issues regarding confusion about testing have popped up in the news recently. This LA Times story covers a new study in the journal Cancer, in which researchers surveyed 1,878 internists, family physicians and OB/GYNs (you can see the study itself here). Their results found that doctors may not promote genetic screening often enough in women who are at high risk of ovarian cancer, while at the same time, they may push screening too heavily for women at average risk.
In other news, the American College of Obstetricians and Gynecologists announced recently that mammograms should be offered to women annually starting at age 40, instead of every one to two years starting at 40, then moving up to annually at age 50.
Different reputable organizations, like the American Cancer Society and the US Preventive Services Task Force, offer different recommendations for when women should start having mammograms.
What does all this matter? Well, if you get screenings too often, you might be opening the door more times to possible complications. Some screenings expose you to radiation (like mammograms), which is not a trivial concern. Screenings in general may force you to take actions that could harm your health (Do I get a biopsy to learn more about this ambiguous lump or not?) and set you on the path to getting life-changing surgeries that you may or may not have actually needed.
If you get screenings spaced too far apart or start them too late, a cancer or other health problem might get a bigger head-start, and you may not catch it early enough.
What's the best answer? Your best shot at getting screenings at the correct time is to have a good relationship with a primary care provider. Your doctor should be familiar with your family history of diseases, your own medical background and the concerns that are most important to you.
In response, you should get regular checkups, understand what risks pose a threat to your health (your weight, smoking, drinking, sexual practices and your family history), and keep a general knowledge of which screenings may be necessary starting on all the big birthdays (especially 20, 30, 40 and 50).
For even more tips on how to get better health and need the health care system less, check out Dr. Cynthia Haines' book The New Prescription: How to Get the Best Health Care in a Broken System(HCI Books, Dr. Cynthia Haines and Eric Metcalf). This is a book about getting what you really want: better health on your own terms. More medical care doesn't mean better health. Dr. Cynthia Haines and Metcalf reveal some of the most egregious problems with a medical system gone awry, opening readers' eyes to how to better navigate the changes underway. Using solid research, insiders' insights, and patient anecdotes, they offer cost-effective and potentially life-saving ways to get more out of health care while using less of it.
Follow Dr. Cindy Haines on Twitter: www.twitter.com/drcindyhaines