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Review article: Biomedical intelligence

Vol. 145 No. 0506 (2015)

Check-up examination: recommendations in adults

  • Vanessa Virgini
  • Claudine Meindl-Fridez
  • Edouard Battegay
  • Lukas U. Zimmerli
DOI
https://doi.org/10.4414/smw.2015.14075
Cite this as:
Swiss Med Wkly. 2015;145:w14075
Published
25.01.2015

Summary

Check-up examinations, or periodic health examinations (PHEs), have gained in importance during the last decades and are nowadays among the most common reasons for consultations in primary care settings. The aim of PHEs is to identify risk factors and early signs of disease, but also to prevent future illness by early intervention. Therefore, each PHE should include counselling, immunisation and physical examination according to the patient’s age and gender. However, deciding whether to screen a patient and choosing the most appropriate screening method can be challenging for general practitioners. The U.S. Preventive Service Task Force (USPSTF) provides updated recommendations on different existing preventive care measures based on relevant literature review. The aim of this review is to provide an updated statement of recommendations regarding preventive care measures based mostly on the guidelines derived from the USPSTF and the Swiss Medical Board. Among the major updates, there is no recommendation anymore to routinely screen for breast cancer and prostate cancer in asymptomatic adults. Since 2013, however, the USPSTF recommends annual screening for lung cancer with low-dose CT in patients aged 55 to 80 years with a smoking history of ≥30 pack years. During PHEs, the physician should be alert to the patients’ hidden agendas, which are the reason for one third of all consultations in primary care.

References

  1. Mehrotra A, Zaslavsky AM, Ayanian JZ. Preventive health examinations and preventive gynecological examinations in the United States. Arch Intern Med. 2007;167:1876–83.
  2. IMS Health. Top 10 reasons for physician visits in Canada. In, Canadian disease and therapeutic index; 2009. Available from: http://www.stacommunications.com/journals/cpm/2010/04–April-2010/CPM_035.pdf
  3. Sox HC. The health checkup: was it ever effective? Could it be effective? JAMA. 2013;309:2496–7.
  4. Prochazka AV, Caverly T. General health checks in adults for reducing morbidity and mortality from disease: summary review of primary findings and conclusions. JAMA Intern Med. 2013;173:371–2.
  5. Dobell H. Lectures on the Germs and Vestiges of Disease, and on the Prevention of the Invasion and Fatality of Disease by Periodical Examinations. London: Churchill; 1861.
  6. Han PK. Historical changes in the objectives of the periodic health examination. Ann Intern Med. 1997;127:910–7.
  7. Edie E. Health examinations past and present and their promotion in Pennsylvania. Am J Publ Health. 1925;15:602–6.
  8. Fisk EC, Crawford JR. How to Make the Periodic Health Examination; A Manual of Procedure. New York: Macmillan; 1927.
  9. Knight A. The value of the periodic examinations in life insurance policyholders. Proceedings of the Association of Life Insurance Medical Directors of America 1921–22;8:25.
  10. Emerson H. Periodic medical examinations of apparently healthy persons. JAMA. 1923;80:1376–81.
  11. Wilson JMG, Jungner G. Principles and Practice of Screening for Disease. Geneva: World Health Organization; 1968
  12. Frame PS, Carlson SJ. A critical review of periodic health screening using specific screening criteria. Part 4: selected miscellaneous diseases. J Fam Pract. 1975;2:283–9.
  13. Frame PS, Carlson SJ. A critical review of periodic health screening using specific screening criteria. 3. Selected diseases of the genitourinary system. J Fam Pract. 1975;2:189–94.
  14. Frame PS, Carlson SJ. A critical review of periodic health screening using specific screening criteria. Part 2: Selected endocrine, metabolic and gastrointestinal diseases. J Fam Pract. 1975;2:123–9.
  15. Frame PS, Carlson SJ. A critical review of periodic health screening using specific screening criteria. Part 1: Selected diseases of respiratory, cardiovascular, and central nervous systems. J Fam Pract. 1975;2:29–36.
  16. The periodic health examination. Canadian Task Force on the Periodic Health Examination. Can Med Assoc J. 1979;121:1193–254.
  17. U.S. Preventive Service Task Force. Guide to clinical preventive services: an assessment of the effectiveness of 169 interventions: report of the U.S. Preventive Services Task Force. Baltimore: Williams & Wilkins; 1989
  18. U.S. Preventive Service Task Force [Internet]. http://www.uspreventiveservicetaskforce.org/congressrep.htm
  19. U.S. Preventive Service Task Force [Internet]. http://www.uspreventiveservicestaskforce.org/uspstf/grades.htm
  20. Swiss Medical Board [Internet]. http://www.medical-board.ch.
  21. Tengs TO, Adams ME, Pliskin JS, Safran DG, Siegel JE, Weinstein MC, et al. Five-hundred life-saving interventions and their cost-effectiveness. Risk Anal. 1995;15:369–90.
  22. Moyer VA. Behavioral counseling interventions to promote a healthful diet and physical activity for cardiovascular disease prevention in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012;157:367–71.
  23. U.S. Preventive Service Task Force. Behavioral counseling in primary care to promote a healthy diet: recommendations and rationale. Am J Prev Med. 2003;24:93–100.
  24. Stead LF, Buitrago D, Preciado N, Sanchez G, Hartmann-Boyce J, Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev 2013;5:CD000165
  25. Bundesamt für Gesundheit [Internet]. http://www.bag.admin.ch.
  26. Schroeder SA. What to do with a patient who smokes. JAMA: the journal of the American Medical Association. 2005;294:482–7.
  27. Counseling and interventions to prevent tobacco use and tobacco-caused disease in adults and pregnant women: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2009;150:551–5.
  28. Fiore MC, Baker TB. Clinical practice. Treating smokers in the health care setting. N Engl J Med. 2011;365:1222–31.
  29. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA: the journal of the American Medical Association 2004;291:1238–45.
  30. Bertholet N, Daeppen JB, Wietlisbach V, Fleming M, Burnand B. Reduction of alcohol consumption by brief alcohol intervention in primary care: systematic review and meta-analysis. Arch Intern Med. 2005;165:986–95.
  31. Kaner E, Bland M, Cassidy P, Coulton S, Deluca P, Drummond C, et al. Screening and brief interventions for hazardous and harmful alcohol use in primary care: a cluster randomised controlled trial protocol. BMC public health. 2009;9:287.
  32. Fleming MF, Mundt MP, French MT, Manwell LB, Stauffacher EA, Barry KL. Brief physician advice for problem drinkers: long-term efficacy and benefit-cost analysis. Alcohol Clin Exp Res. 2002;26:36–43.
  33. Moyer VA. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: U.S. preventive services task force recommendation statement. Ann Intern Med. 2013;159:210–8.
  34. Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro, MG. Audit- The Alcohol Use Disorders Identification Test. Guidelines for Use in Primary Care. Geneva: World Health Organization; 2001.
  35. Maisto SA, Saitz R. Alcohol use disorders: screening and diagnosis. The American journal on addictions / American Academy of Psychiatrists in Alcoholism and Addictions 2003;12(Suppl 1):S12–25.
  36. Behavioral counseling to prevent sexually transmitted infections: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;149:491–496, W495.
  37. Kamb ML, Fishbein M, Douglas JM, Jr., Rhodes F, Rogers J, Bolan G, et al. Efficacy of risk-reduction counseling to prevent human immunodeficiency virus and sexually transmitted diseases: a randomized controlled trial. Project RESPECT Study Group. JAMA. 1998;280:1161–7.
  38. Lin JS, Whitlock E, O'Connor E, Bauer V. Behavioral counseling to prevent sexually transmitted infections: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2008;149:497–508, W496–499.
  39. Gross PA, Hermogenes AW, Sacks HS, Lau J, Levandowski RA. The efficacy of influenza vaccine in elderly persons. A meta-analysis and review of the literature. Ann Intern Med. 1995;123:518–27.
  40. Gardner P, Schaffner W. Immunization of adults. N Engl J Med. 1993;328:1252–8.
  41. Eng P, Lim LH, Loo CM, Low JA, Tan C, Tan EK, et al. Role of pneumococcal vaccination in prevention of pneumococcal disease among adults in Singapore. Int J Gen Med. 2014;7:179–91.
  42. Australian Government- The department of health [Internet]. http://www.immunise.health.gov.au.
  43. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Bohm M, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31:1281–357.
  44. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Bethesda (MD); 2004.
  45. Screening for high blood pressure: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2007;147:783–6.
  46. Screening for abdominal aortic aneurysm: recommendation statement. Ann Intern Med. 2005;142:198–202.
  47. Fleming C, Whitlock E, Beil T, Lederle F. Screening for Abdominal Aortic Aneurysm: A Best-Evidence Systematic review for the U.S. Preventive Service Task Force. AHRQ Pub No 05–0569–B 2005.
  48. Flegal KM, Graubard BI, Williamson DF, Gail MH. Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA. 2007;298:2028–37.
  49. Barton M. Screening for obesity in children and adolescents: US Preventive Services Task Force recommendation statement. Pediatrics. 2010;125:361–7.
  50. Moyer VA. Screening for and management of obesity in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012;157:373–8.
  51. Helfand M, Carson S. Screening for Lipid Disorders in Adults: Selective Update of 2001 U.S. Preventive Service Task Force Review. AHRQ Publication No 08–05114–EF-1 2008
  52. Swiss Atherosclerosis Association [Internet]. http://www.agla.ch.
  53. Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, et al. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J. 2011;32:1769–818.
  54. Downs JR, Clearfield M, Weis S, Whitney E, Shapiro DR, Beere PA, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA. 1998;279:1615–22.
  55. Doser Joz-Roland N, Büla C, Rodondi N. Faut-il traiter les dyslipidémies chez les personnes âgées et très âgées? Rev Med Suisse. 2009;5:2211–8.
  56. Ray KK, Seshasai SR, Erqou S, Sever P, Jukema KW, Ford I, et al. Statins and all-cause mortality in high-risk primary prevention: a meta-analysis of 11 randomized controlled trials involving 65,229 participants. Arch Intern Med. 2010;170:1024–31.
  57. Screening for osteoporosis: U.S. preventive services task force recommendation statement. Ann Intern Med. 2011;154:356–64.
  58. FRAX- WHO Rechnet zur Bestimmung des Frakturrisikos [Internet]. http://www.shef.ac.uk/FRAX/?lang=de.
  59. National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis. In. Washington, DC: National Osteoporosis Foundation; 2014
  60. Moyer VA. Vitamin D and calcium supplementation to prevent fractures in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;158:691–6.
  61. Screening for depression in adults: U.S. preventive services task force recommendation statement. Ann Intern Med. 2009;151:784–92.
  62. Whooley MA, Avins AL, Miranda J, Browner WS. Case-finding instruments for depression. Two questions are as good as many. J Gen Intern Med. 1997;12:439–45.
  63. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;149:627–37.
  64. Hewitson P, Glasziou P, Irwig L, Towler B, Watson E. Screening for colorectal cancer using the faecal occult blood test, Hemoccult. Cochrane Database Syst Rev 2007:CD001216
  65. Whitlock EP, Lin JS, Liles E, Beil TL, Fu R. Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2008;149:638–58.
  66. Manser CN, Bachmann LM, Brunner J, Hunold F, Bauerfeind P, Marbet UA. Colonoscopy screening markedly reduces the occurrence of colon carcinomas and carcinoma-related death: a closed cohort study. Gastrointest Endosc. 2012;76:110–7.
  67. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.
  68. Andrae B, Andersson TM, Lambert PC, Kemetli L, Silfverdal L, Strander B, et al. Screening and cervical cancer cure: population based cohort study. BMJ. 2012;344:e900.
  69. Johannesson G, Geirsson G, Day N. The effect of mass screening in Iceland, 1965–74, on the incidence and mortality of cervical carcinoma. Int J Cancer. 1978;21:418–25.
  70. Moyer VA. Screening for cervical cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012;156:880–891, W312.
  71. Screening for type 2 diabetes mellitus in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;148:846–54.
  72. Standards of medical care in diabetes – 2014. Diabetes Care. 2014;37(Suppl 1):S14–80.
  73. Moyer VA. Screening for coronary heart disease with electrocardiography: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012;157:512–8.
  74. Karius P, Schuetz GM, Schlattmann P, Dewey M. Extracardiac findings on coronary CT angiography: a systematic review. J Cardiovasc Comput Tomogr. 2014;8:174–182 e171–176.
  75. Garber JR, Cobin RH, Gharib H, Hennessey JV, Klein I, Mechanick JI, et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Thyroid. 2012;22:1200–35.
  76. Aoki Y, Belin RM, Clickner R, Jeffries R, Phillips L, Mahaffey KR. Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999–2002). Thyroid. 2007;17:1211–23.
  77. Hollowell JG, Staehling NW, Flanders WD, Hannon WH, Gunter EW, Spencer CA, et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab. 2002;87:489–99.
  78. Screening for thyroid disease: recommendation statement. Ann Intern Med. 2004;140:125–7.
  79. Gencer B, Collet TH, Virgini V, Bauer DC, Gussekloo J, Cappola AR, et al. Subclinical thyroid dysfunction and the risk of heart failure events: an individual participant data analysis from 6 prospective cohorts. Circulation. 2012;126:1040–9.
  80. Rodondi N, den Elzen WP, Bauer DC, Cappola AR, Razvi S, Walsh JP, et al. Subclinical hypothyroidism and the risk of coronary heart disease and mortality. JAMA. 2010;304:1365–74.
  81. Selmer C, Olesen JB, Hansen ML,von Kappelgaard LM, Madsen JC, Hansen PR et al. Subclinical and overt thyroid dysfunction and risk of all-cause mortality and cardiovascular events: a large population study. J Clin Endocrinol Metab. 2014;99:2372–82.
  82. Moyer VA. Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160:330–8.
  83. American Cancer Society. Cancer Facts & Figures 2013. In. Atlanta, GA: American Cancer Society; 2013.
  84. Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365:395–409.
  85. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;151:716–26, W-236.
  86. Biller-Andorno N, Juni P. Abolishing mammography screening programs? A view from the Swiss Medical Board. N Engl J Med. 2014;370:1965–7.
  87. Gotzsche PC, Jorgensen KJ. Screening for breast cancer with mammography. Cochrane Database Syst Rev 2013;6:CD001877.
  88. Howladder N, Noone A, Krapcho M, Neyman N, Aminou R, Waldron W, et al. SEER Cancer Statistics Review, 1975–2008, National Cancer Institute. In. Bethesda, MD; 2011.
  89. Gasser T, Iselin C, Jichlinski P, Kreienbühl B, Merz V, Recker F, et al. PSA-Bestimmung – Empfehlungen der Schweizerischen Gesellschaft für Urologie (SGU). Schweiz Med Forum. 2012;12:126–8.
  90. Moyer VA. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012;157:120–34.
  91. Croswell JM, Kramer BS, Kreimer AR, Prorok PC, Xu JL, Baker SG, et al. Cumulative incidence of false-positive results in repeated, multimodal cancer screening. Ann Fam Med. 2009;7:212–22.
  92. Raaijmakers R, Kirkels WJ, Roobol MJ, Wildhagen MF, Schrder FH. Complication rates and risk factors of 5802 transrectal ultrasound-guided sextant biopsies of the prostate within a population-based screening program. Urology. 2002;60:826–30.
  93. Chou R, Croswell JM, Dana T, Bougatsos C, Blazina I, Fu R, et al. Screening for prostate cancer: a review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2011;155:762–71.
  94. Chou R, Dana T, Bougatsos C, Fu R, Blazina I, Gleitsmann K, Bruin Rugge J. Treatments for Localized Prostate Cancer: Systematic Review to Update the 2002 U.S. Preventive Services Task Force Recommendation. AHRQ Pub No 12–05161–EF-1 2011.
  95. Hunziker S, Schlapfer M, Langewitz W, Kaufmann G, Nuesch R, Battegay E, Zimmerli L. Open and hidden agendas of “asymptomatic” patients who request check-up exams. BMC Fam Pract. 2011;12:22.
  96. Brody DS, Miller SM, Lerman CE, Smith DG, Lazaro CG, Blum MJ. The relationship between patients' satisfaction with their physicians and perceptions about interventions they desired and received. Med Care. 1989;27:1027–35.
  97. Jackson JL, Kroenke K. Patient satisfaction and quality of care. Mil Med. 1997;162:273–7.
  98. Joos SK, Hickam DH, Borders LM. Patients’ desires and satisfaction in general medicine clinics. Public Health Rep. 1993;108:751–9.
  99. Kravitz RL, Callahan EJ, Paterniti D, Antonius D, Dunham M, Lewis CE. Prevalence and sources of patients’ unmet expectations for care. Ann Intern Med. 1996;125:730–7.
  100. Kravitz RL, Cope DW, Bhrany V, Leake B. Internal medicine patients' expectations for care during office visits. J Gen Intern Med. 1994;9:75–81.
  101. Howard-Tripp M. Should we abandon the periodic health examination?: YES. Can Fam Physician. 2011;57:158–6.
  102. Rank B. Executive physicals – bad medicine on three counts. N Engl J Med. 2008;359:1424–5.
  103. Boulware LE, Marinopoulos S, Phillips KA, Hwang CW, Maynor K, Merenstein D, et al. Systematic review: the value of the periodic health evaluation. Ann Intern Med. 2007;146:289–300.
  104. Mavriplis CA. Should we abandon the periodic health examination?: NO. Can Fam Physician. 2011;57:159–61.
  105. Yarnall KS, Pollak KI, Ostbye T, Krause KM, Michener JL. Primary care: is there enough time for prevention? Am J Public Health. 2003;93:635–41.
  106. Krogsboll LT, Jorgensen KJ, Gronhoj Larsen C, Gotzsche PC. General health checks in adults for reducing morbidity and mortality from disease. Cochrane Database Syst Rev 2012;10:CD009009.
  107. Cass RM. General health checks in adults. JAMA Intern Med. 2013;173:1657–8.
  108. Prochazka AV, Lundahl K, Pearson W, Oboler SK, Anderson RJ. Support of evidence-based guidelines for the annual physical examination: a survey of primary care providers. Arch Intern Med. 2005;165:1347–52.
  109. American Board of Internal Medicine Foundation [Internet]. http://www.choosingwisely.org.
  110. Gaspoz J. Die SGIM startet ihre Kampagne “Smarter Medicine” mit der ersten “Top-5–Liste” der Schweiz. Schweizerische Ärztezeitung 2014;95:765.
  111. U.S. Preventive Service Task Force [Internet]. http://www.uspreventiveservicestaskforce.org/recommendations.htm

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