Is disease screening considered a physical examination?

Judging from the general public perception and the scope of commercial physical examination services, disease screening is indeed part of the physical examination.； However, in the professional subdivision context of public health and clinical practice, the boundary between the two is actually quite clear, and many practitioners even clearly separate the two.

I have been doing health consulting in a physical examination center for almost five years, and I have met many people who are confused by this problem. Last week, there was a young man who worked on the Internet. The routine physical examinations arranged by the company every year were all normal. Recently, because his family was diagnosed with lung cancer, I went to make an appointment for early lung cancer screening with low-dose spiral CT, and found a 5mm ground glass nodule. His first sentence at the time was, "Isn't early screening an item of physical examination?" Why didn't I check my previous physical examination? ”

You see, this is the source of poor cognition - what we usually call "routine physical examination" is essentially a universal health examination, which is equivalent to a basic annual physical examination. It checks basic items such as blood routine, liver and kidney function, ordinary chest X-ray, and abdominal color ultrasound that are applicable to most people, and covers common health abnormalities. Disease screening is precisely aimed at a certain type of disease, either for high-risk groups or for diseases with high incidence and good prognosis if diagnosed early, such as cervical cancer screening for women and colorectal cancer screening for people over 40 years old. The goal is to detect early lesions before symptoms appear. Many times these items are available as additional items for physical examination, so everyone naturally thinks that "screening is part of the physical examination."

However, when I talked with many friends who work in public health, they did not agree with this statement. In the context of public health, disease screening is a systematic project for specific groups. For example, a community provides free stroke screening to all permanent residents over 45 years old in the jurisdiction. It has unified screening standards, clear health economic evaluations, and follow-up follow-up intervention processes. It is completely different from individual self-selected and commercialized physical examinations. Even many screening programs are not recommended for low-risk groups. For example, young people with no family history of lung cancer and non-smokers, if they follow the trend and do low-dose spiral CT, they will have unnecessary risks of radiation exposure. If they randomly check tumor markers and show false positives, they will in vain add to themselves several months of anxiety.

A 24-year-old girl came for consultation before, saying that she had no sexual history. She went to a physical examination institution and was tricked into adding HPV and TCT cervical cancer screening programs, which cost more than a thousand. In fact, according to clinical guidelines, there was no need for her to do so. This is the pitfall of confusing screening with ordinary physical examinations - many institutions will package high-premium screening items as "upgrade options" for routine physical examinations. Regardless of whether you meet the applicable group, a single promotion will waste money and may be burdensome.

In fact, there is really no need to worry about the nominal issue of "whether screening counts as a physical examination". No matter what it is called, the core is to choose the items that match your health situation: for ordinary people without special risks, a routine basic physical examination is enough.； If you have high-risk factors such as family history and bad living habits, take the initiative to seek evaluation from a doctor and add corresponding screening items. Don’t make blind choices or miss out on necessary ones.