Early diagnosis is one of the most important aspects of preventive care. If one gets an early diagnosis, they can handle their ailment better and be prepared for what’s coming. “They have more chances of recovery, more chances of beating the condition. It is, therefore, important to ensure you are screened and tested on time and at periodic frequency to prevent any issues,” said Dr Amitabh Parti, director, internal medicine, Fortis Memorial Research Institute Gurugram.
In the wake of the COVID-19 pandemic and the exigency measures that it continues to prompt, this World Health Day — observed annually on April 7 under the auspices of World Health Organization (WHO) — let’s understand how to ‘build a fairer, healthier world’ by drawing attention to the need and importance of preventive health checkups for everyone.
“A healthy lifestyle and preventive screening are the two pillars of combating the onset of non-communicable diseases (NCDs). Regular checkups can help in the identification and diagnosis of health conditions in a timely manner. Irrespective of whether a person has a family history of diseases, regular screening should be done over 25 years of age. This is because there are some diseases which become more common with age,” said Dr Vishal Sehgal, medical director, Portea Medical, talking about diseases such as diabetes, cardiovascular diseases etc., which are a “combination of genetic, physiological, environmental and behavioural factors”, and kill 41 million people each year, equivalent to 71 per cent of all deaths globally as per WHO.
Often, “any dangerous condition” do not show clear signs and symptoms until they become severe. “A timely diagnosis can not only keep a check on health, but also help address any potential complications in a timely manner,” added Added Dr Sehgal.
For most chronic diseases, the risk factors are well-known, mentioned Dr Radha Rangarajan, CSO HealthCube. “For example, hypertension is the biggest risk factor for cardiovascular disease (CVD). But, it can go undetected for years, as people do not get their blood pressure checked regularly. Detection of hypertension and treatment, if needed, can keep a person healthy for decades,” said Dr Rangarajan.
So, what kind of health checkups should you go for?
Screening is generally done in healthy people who do not have any symptoms. Dr Rangarajan said the tests measure parameters that can go awry before the onset of the actual condition, leading to the prevention of the disease.
“A full blood work is recommended at least twice in a year – where your HBA1C, HDL, LDL, Triclonides, Kidney Function, SGOT, SGPT, Vitamin D 3, Vitamin B 12, T3, T4, TSH are tested for,” said Dr Parti talking about the routine checkups that all of us should do.
Dr Gaurav Jain, consultant, internal medicine, Dharamshila Narayana Superspeciality Hospital also shared how one should look at categorising regular health checkups as per age that should be done after every three years.
Under 19 to 20 years of age (after every three years):
• Hormonal disorders, etc.
Between 20 to 40 years of age (after every three years):
• Heart health
• Urine infection
• Chest Infection, etc.
Above 40 years of age (after every three years):
• Heart health
• Bone Health
• Kidney health
• Liver health
Above 60 years of age:
• All of the above mentioned, every year
Women and health checkups
“Along with the tests mentioned above, women over 40 years of age should go for breast screening. Also between 20 to 30 years of age, women should opt for pap smear test to reduce the risk of cervical cancer,” mentioned Dr Jain.
According to Amol Naikawadi, joint managing director, Indus Health Plus, preventive health checkups should be “personalised” based on a person’s history i.e. the clinical background, age, lifestyle and habits. “Go for regular screenings and take corrective action and maintain follow-up regarding the same. We should not wait for symptoms to come and then go for checkups. Preventive checkups should be done routinely. Normally these checkups include some blood tests and some basic radiological tests like chest X ray etc. But it all depends on the individual’s parameters and that is the essence of such checkups,” he said.
Can these tests predict future diseases?
Health checkups can identify the health risks in the future or the current health status. “Some predisposing risk factors can be identified at a very early stage and these need to be kept under control to avoid certain related health conditions which may develop subsequently. For example, diabetic nephropathy is a kidney condition that occurs in uncontrolled or poorly managed diabetics over a period of time. So, a simple blood test like Hba1c or fasting sugar can identify the risk of developing diabetes and hence adequate precautions taken in time can prevent its complications as well. Genetic testing, which identifies genetic tendencies, can also help us focus on the areas which need to be monitored,” said Amol Naikawadi, joint managing director, Indus Health Plus.
Are the health parameters followed in India at par with the globally accepted standards?
Globally, the health standards are a group of quality and health performance indicators that are monitored and observed periodically to ensure good health quality, mentioned Naikawadi. India ranked 145 among 195 countries in healthcare access and quality according to 2018 The Lancet study. “The data collection, surveillance strategies and statistics are used to improve healthcare practices. There are clinical care pathways defined and there is a lot of vigilance that comes in place. In India, the clinical practice guidelines are as per the world-class standards but we need to improve upon our data and uniformity in health care across the nation including the small towns and primary level,” he mentioned.
Are Indian testing standards a little less stringent than those of developed countries? “That is a myth,” said Dr Manisha Arora, senior consultant, internal medicine, Sri Balaji Action Medical Institute. According to Dr Arora, the standard medical tests (in India) are at par with the world. Only a few aspects may differ owing to culture, climate, certain common diseases etc. For instance, vitamin B 12 is a common deficiency found in vegetarians in India and so is all over the world. But no way the standards of testing are different,” Dr Arora told indianexpress.com.
Why is preventive checkup important?
Just like a simple measure of wearing a seat belt could help prevent deaths in case of road accidents — a fact pointed out by the Ministry of Road Transport and Highways of how 15 people die each day in India — preventive health checkups are easier and inexpensive, and in many cases, unobtrusive. While only an abysmal 6.8 per cent of the overall healthcare expenditure was spent on preventive healthcare, according to the National Health Accounts, 2016-17, more than 95 per cent of overall healthcare expenses went into treating diseases and their complications.
Agreed Dr Jain while pointing out the following reasons:
*Lesser chances of organ failure are ensured. As chronic diseases like diabetes, hypertension, lung cancer and infection, heart disease etc. are directly associated with the functioning of major organs of the body, they are surely more at the risk of getting severely affected.
*With early diagnosis of cancers, one has more chances of recovery without numerous episodes of chemotherapy or radiotherapies.
*The more chronic the disease the more possibility of consuming medicines. Consuming more medicine is surely not good for kidney health, and the patient needs to be extra cautious as taking medication is also important. Early diagnosis can ensure lesser consumption of medicines.
*In many cases, women-centric cancers are majorly diagnosed late in our country, hence we witness rising disappointing data of cervical cancers and breast cancers. “That, too, when both of them are entirely curable with early recovery possible. More awareness needs to be spread in this regard,” said Dr Jain.
To sum it up, preventive healthcare is better than curative healthcare, which is possible by tackling NCDs first to avoid further health complications.