What items should be done in routine physical examination

There is no unified fixed package for routine physical examination. The core is basic must-do items plus personalized adjustments. A basic package in the range of 300-600 yuan is enough for healthy ordinary people. There is no need to blindly pursue luxury packages worth tens of thousands of dollars.

You can go to a public physical examination center and ask about the most basic inclusive package. It basically covers basic physical signs such as height, weight, blood pressure and blood oxygen, three routine hematuria and stool, four basic biochemical items such as liver and kidney function, fasting blood sugar and blood lipids, plus chest X-ray, abdominal color ultrasound and basic medical and surgical palpation. This set of screening can basically identify high-risk problems such as hypertension, hyperlipidemia, diabetes, liver and kidney dysfunction, and common organ nodules, which is fully sufficient to meet the needs of annual routine screening.

A while ago, I accompanied an elder in my family for a physical examination. The front desk kept trying to sell a package that added tumor markers and cancer gene testing. The package cost more than 2,000 yuan, so I stopped him. The elder had no other underlying diseases except high blood pressure, and no family history of cancer. If these items were checked, it would be easy to get into trouble due to false positives. I once had a colleague who was 32 years old and had no underlying diseases. He followed the trend and added a full set of tumor markers. As a result, the CA724 level was twice as high. He was so scared that he had a gastroscopy, a colonoscopy, and a full-abdominal CT scan. He spent thousands. In the end, nothing happened. He just developed chronic gastritis from eating takeout every day during that period. Ordinary people without high-risk factors really don’t need to check for such items regularly.

The most controversial thing about physical examination items on the Internet now is whether high-end screening items, such as PET-CT, are worth doing. Some bloggers say that doing it once a year can screen out all cancers in the whole body. In fact, clinical guidelines have long made it clear that it is not recommended for healthy people to do it routinely. The amount of radiation in one session is equivalent to dozens of chest X-rays. For healthy people without high-risk factors, it is simply not worth the gain. However, if there is a clear family history of cancer, or if suspicious nodules have been previously detected and need follow-up, it will be fine according to the doctor's arrangement, and it cannot be killed at once.

Of course, this does not mean that you can only do basic items. Adjusting additional items according to your own situation will be more cost-effective. If you have been smoking for more than ten years, don’t get a regular chest X-ray. Spend more than 200 yuan to switch to a low-dose CT, which is much more sensitive in screening for early-stage lung cancer. If you often stay up late, eat takeout, or like to drink, add hepatitis B and hepatitis C screening and liver elasticity testing to see if there are signs of fatty liver fibrosis. If you have a family history of diabetes, don’t just check fasting blood sugar, add glycated hemoglobin. It can see the average blood sugar level in the past three months, which is much more accurate than a single test. Women who have sex can spend more than 200 per year for TCT+HPV combined screening, which is more effective than hoarding a bunch of expensive gynecological health products. If a direct relative in the family has had colon cancer, regular colonoscopy should be done after the age of 40. Don’t be too troublesome. The cure rate for early screening is almost 100%.

Oh, by the way, don’t believe in the gimmick project that “one drop of blood can detect all diseases”. Before choosing a project, you can tell the doctor at the physical examination center about your medical history and living habits. The advice given by others is much more reliable than reading ten internet celebrity guides.