Is health screening or treatment always a good thing? We asked leading experts to examine the scientific evidence behind popular treatments, including acupuncture and prostate screening, so you can make the right choices for your health.
There’s a growing body of scientific concern that some testing is overdiagnosing patients – finding medical problems that may never cause harm, but can lead to an unnecessary diagnosis and avoidable distress.
But we also know that many lives are saved by early detection and appropriate treatment. So – from diagnostic tests to complementary and paid-for treatments – how do you make an informed decision that’s right for you?
Which? members can read the full article about the six treatments our experts examined in the latest issue of Which? and in our online archive. If you’re not a Which? member, sign up to Which? for £1 to read the article online and get access to our full product reviews – ranging from blood pressure monitors to TVs.
Here are five key things you need to know about health treatments:
1. Not all health screenings are completely accurate
It may sound obvious, but no treatment or screening is perfect. It’s up to you to weigh up the pros and cons.
For example, when it comes to bowel screening – carried out using a stool-testing kit called the faecal occult blood (FOB) kit – a positive result could mean one of several things. For every 1,000 people who take the test, 20 have a positive result and probable further investigations (colonoscopy). Of these:
- Nine of these will turn out to have a normal bowel (‘false positive result’),
- Nine will have bowel polyps,
- Two will have bowel cancer.
So a positive FOB result does not equal bowel cancer and can mean further investigations, which carry a small risk. And some bowel cancers will be missed (a ‘false negative’ result).
In the UK, these kits are sent out every two years to 60 to 74-year-olds (50 to 59 in Scotland). If you have symptoms, such as a persistent change in bowel habit, don’t wait for screening – see your GP.
2. There’s not always evidence that a common health treatment works
The dental scale and polish has been around for a long time, so you’d expect there to be evidence that it works, right? Not necessarily.
There’s good evidence that it benefits the 10 to 20% of us with severe gum disease and can help prevent tooth loss, but it’s not so clear for the rest of us.
There are big trials due to report back in 2017, but until then you might like to ask your dentist whether the treatment is necessary.
3. Health screenings do not provide a simple answer
The simple but controversial prostate screening Prostate Specific Antigen (PSA) blood test is a good example of this. It detects PSA, which is secreted into the bloodstream by the prostate gland, because the PSA level is often raised in men with prostate cancer.
But the research studies our experts examined don’t come to the same conclusions on whether prostate screening and testing reduces death from prostate cancer and benefits those who have it.
4. Complementary therapies: your world view matters
If you have complementary therapies, such as acupuncture or chiropractic, you’ll be aware that some of the benefits may be due to placebo or non-specific effect – such as the attention of a caring acupuncturist.
But whether you still believe it works, and would choose to have it, depends very much on your world view. For example, you might take the view that it doesn’t matter what the active ingredient is: if a complementary therapy works for you, then it works.
5. The numbers count
When deciding whether to have a treatment, you’ll want to ask about the numbers. For example, GP surgeries can offer dementia screening to those over 75 (over 60 with particular conditions such as high blood pressure or heart disease).
But our experts say that we don’t really know if this screening works. The problem is with its accuracy.
- If six in 100 of the population has dementia, our current tests would correctly pick up four of them,
- Miss two who do have dementia,
- And tell another 23 perfectly normal people that they potentially have dementia, with associated distress.
What you should do
Which? editor Richard Headland said: ‘The evidence for having common health treatments or screening isn’t always conclusive so it’s important to get as much information as possible before making a decision, and talk to a health professional about the risks and benefits for your personal situation.’