Is cancer screening useful? Is it a waste of money?

Many people either talk about "cancer" in a disgraceful way, or they think that cancer is far away from them. The lack of medical knowledge may even slowly lead people to cancer.

The World Health Organization Cancer Committee has clearly stated that 2/3 of cancers can be prevented and cured. The key is early detection through physical examination.

Following this, medical and health institutions in various places have launched various physical examination services to meet people's needs. However, a few drops of blood can detect whether you have cancer; once scanned with a cancer detection "artifact", early-stage cancer will appear immediately... The prices of these various physical examination items range from a few hundred to tens of thousands of yuan, which makes the public a little confused. Can't understand.

How to get a cancer prevention physical examination? What are the cancer prevention physical examinations we usually do? What kind of cancer prevention physical examination can help you avoid "bad luck" as much as possible and live a safe life?

I can’t understand the physical examination package

In fact, more and more people are now paying attention to cancer prevention. Ms. Tang, 53, has been thinking about getting a special cancer check-up recently. Previously, one of her friends was diagnosed with gastric cancer, which was in the advanced stage. "His workplace organizes physical examinations every year, but it still hasn't been detected. It seems that he still needs to have a special cancer prevention physical examination."

After consulting many hospitals, Ms. Tang hesitated: the prices and items of various anti-cancer physical examination packages are different, some are a few hundred yuan, and some are nearly 10,000 yuan. There are dozens of items inspected, and it is unclear which items are "hard goods" and which are "bulk goods."

The "anti-tumor physical examination package" of a professional physical examination institution is priced at 990 yuan, and the online group purchase price is 480 yuan. It checks 26 items, including 8 tumor marker screenings. A cancer prevention physical examination package launched by a hospital costs 1,678 yuan, and the online group purchase price is 866 yuan. It checks more than 80 items, including 4 tumor marker screenings.

Another hospital launched a high-end physical examination package with a price of 11,000 yuan and about 50 examination items. The reporter found that the examination items of this package are roughly the same as those of other hospitals. The most obvious difference is that it includes PET-CT examination, which alone costs about 8,000 yuan.

Must everyone take the “magic tool” for cancer screening?

PET-CT is a high-end medical imaging diagnostic equipment that can achieve the purpose of early detection of some functional changes in the body and diagnosis of diseases. Therefore, in recent years, it has become the "new favorite" of anti-cancer physical examinations, especially by Favored by high-income people, although it is expensive, many people still regard it as an "artifact" for cancer detection and must "scan" it. Currently, among high-end physical examination packages, PET-CT is a popular recommended option.

PET-CT is a must for cancer prevention physical examination? Oncology experts believe that treating PET-CT as an "artifact" for cancer screening is actually misleading. Experts say that the real role of PET-CT is not in screening, but in diagnosing the extent of the tumor, such as checking whether the tumor has recurred or metastasized to other parts of a patient.

In recent years, some people in the industry have questioned that using expensive PET-CT to screen normal people for tumors is not only a waste of resources, but also may involve risks such as radiation, and it is not effective for all tumors. "Catch them all in one go." Liu Desen also believes that for ordinary people, there is no need to choose this item in the cancer prevention physical examination.

With the improvement of medical technology, there are currently many screening methods to choose from, such as B-ultrasound, painless endoscopy, low-dose CT screening, etc., which are cheap, have low radiation, and have good effects. Combined with The examination of tumor markers can also play a role in preventing cancer.

Abnormal tumor markers will definitely win the bid?

Speaking of "tumor markers", this is another major item in cancer prevention physical examinations. Many physical examination package promotions mention that "a few drops of blood can detect nearly 10 types of cancer." That's right. It is the detection of tumor markers. The presence or changes of such substances can indicate the nature of the tumor.

Currently, almost all physical examinations include two basic tumor marker tests: alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA), which are auxiliary tests for liver cancer and digestive system cancer respectively. Diagnostic indicators. In higher-end physical examination packages, the number of tumor markers has been increased to 13 items, and many physical examination institutions have also specially launched "anti-cancer physical examination packages".

On the website of a well-known physical examination institution, 6 of the 8 physical examination package items include the examination of tumor markers. The male package priced at 586 yuan and the female package priced at 663 yuan both check AFP. , CEA; the male package D priced at 1,641 yuan checks AFP, CEA, T-PSA (total prostate antigen), F-PSA (free prostate antigen); the female package D priced at 1,936 yuan checks APF, CEA, CA125 (sugar class antigen 125) and CA153 (carbohydrate antigen 153).

However, these items are also a major "minefield" in the physical examination report. Any abnormality in these tumor-related indicators can scare people half to death.

At the beginning of this year, citizen Ms. Xu’s work organization organized a physical examination. The physical examination report marked all the items with abnormal results. One of them clearly stated "carcinoembryonic antigen", "It is not an exaggeration at all, look. By the time it was time to report, my legs were weak.”

She thought that if there was something wrong with this indicator, it must be cancer. As a result, she did a round of examinations and found no problem.

According to medical experts, generally speaking, tumor markers can only be used as indicators for tumor patients to monitor their disease development, treatment and recovery, and cannot be used as a standard to judge whether a person has cancer. The serum of healthy people occasionally contains these markers. When they are used for cancer screening, the sensitivity and specificity are very low, so "false positive" results often occur. Therefore, this kind of general tumor detection project is often not effective. Too meaningful.

Most of the tumor markers known today not only exist in malignant tumors, but also in benign tumors, embryonic tissues, and even normal tissues. Therefore, finding elevated tumor markers alone cannot be used as the basis for tumor diagnosis. Therefore, conducting these examinations on healthy people does not reduce the risk of tumor death, but adds a lot of unnecessary worries and additional examinations. One clinician bluntly said that the use of a complete set of tumor markers for screening healthy people is no different from the overprescribing of drugs. Most of them are due to "reasons you know."