Annual Physicals Popular Despite Benefit Doubts

Some doctors who perform annual physicals say they build doctor-patient relations

Some doctors who believe in performing annual physicals say they help build the doctor-patient relationship. Sean Locke hide caption

itoggle caption Sean Locke

Health planning experts can't find any evidence that annual physical exams benefit healthy adults. But a new survey shows that 65 percent of doctors still perform the regular checkups. They say the benefits may be difficult to quantify, but they are real.

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Physicians who believe annual physicals are beneficial often note that the visits allow them to perform certain medical screenings — for blood pressure or cholesterol, for example. But with so many types of screening tests available and promoted by various organizations, how is a patient to know which tests to ask for?

The U.S. Preventive Services Task Force (USPSTF) is a panel of experts that tries to address this question with rigorous science. Looking at evidence from clinical trials, they evaluate the health costs and benefits of screenings. The USPSTF then assigns a recommendation for or against each particular screening. Or, they will declare that "the evidence is insufficient to recommend for or against" a screening.

The standards of the task force are high, and some organizations, like the American Heart Association, recommend screenings that the USPSTF says are not sufficiently supported by evidence. This doesn't mean the screenings aren't worth it for some individuals; it just means that the Task Force didn't find evidence that the benefits clearly outweighed the risks.

As with almost everything in medical care, the screenings physicians perform should be tailored to the age, sex, symptoms and medical history of the individual patient.

Below is an outline of which screenings the USPSTF recommends for adults without disease symptoms. There are several screenings the USPSTF recommends that are not included, because they don't involve lab tests. These include screenings for depression, alcohol misuse, obesity, hearing loss and visual impairment.

USPSTF Recommendations

Abdominal aortic aneurysm: Men only, ages 65-75: one-time screening by ultrasound for people who have smoked at some point in their lives

Blood pressure: Ages 18 and over: screen for high blood pressure

Breast cancer: Women only, ages 40 and over: mammography every one to two years, with or without clinical breast exam

Cervical cancer: Screen women who have been sexually active and who have a cervix; may choose to decline screening after age 65 if not otherwise at risk

Chlamydial infection: Women only, ages 25 and younger; screen sexually active individuals

Colorectal cancer: Adults ages 50 and over; screen using one of several tests

Osteoperosis: Women only, ages 65 and older; screen for bone density

USPSTF Recommendations for Pregnant Women

Anemia: Using hemoglobin or hematocrit

Down syndrome: By serum multiple-marker testing

Hepatitis B: At first prenatal visit

HIV: During prenatal care

Neural tube defects: During prenatal care

Preeclampsia: At first prenatal visit and periodically through rest of pregnancy

Rh incompatibility: For blood type and antibody testing at first prenatal visit

American Heart Association Recommendations

Blood pressure: Screen at least every two years

Body Mass Index: Screen at least every two years

Waist circumference: Screen at least every two years

Pulse: Screen at least every two years

Fasting lipid profile: Measure at least every five years

Risk of coronary heart disease: Assess 10-year risk of CHD with a multiple risk factor score every five years

Compiled by NPR's Katie Unger.

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