RENEE MONTAGNE, HOST:
Bone density scans are among a growing number of medical screenings that are available at local grocery stores, churches and community centers. Some of these tests are being offered by for-profit companies.
And as Jenny Gold reports, these tests can sometimes do harm.
JENNY GOLD, BYLINE: Messiah United Methodist Church in Springfield, Virginia is usually busy for a Thursday morning. It's not a usual time for worship. But parishioner Stacey Riggs and her husband have come for something a little different - a medical screening.
STACEY RIGGS: Because I'm getting ready to turn 50 sooner than I'd like to say, and just thought that it would be a good time to do an overall screening.
GOLD: The church is offering tests by for-profit company LifeLine Screening. One of the selling points is that the tests are mostly non invasive and fairly affordable. For less than $200, Riggs is getting six different screenings for stroke, heart disease and osteoporosis, even though she doesn't have any symptoms.
RIGGS: This seemed to get everything done at one place at a reasonable cost.
UNIDENTIFIED WOMAN: I'm going to clean for you.
GOLD: A health aide leads her to a cot in a back room, and hooks her up to an ultrasound machine to check if she has any plaque in her neck artery that could cause a stroke.
UNIDENTIFIED WOMAN: I'm going to be looking at carotid artery screening to see if you have any plaque buildup.
RIGGS: Oh, carotid artery.
UNIDENTIFIED WOMAN: Yes. So have a seat right here.
GOLD: LifeLine says they've screened eight million Americans this way, mostly by advertising through the mail. Dr. Andy Manganaro says these tests save lives. He's the company's chief medical officer and a vascular surgeon.
DR. ANDY MANGANARO: It was very depressing to get called at 3 o'clock in the morning to see a patient in the emergency room with an already ruptured abdominal aortic aneurism who was near death, knowing that had they known they had the aneurism a week before, we could have fixed it with very little risk to them, and they would have been going home instead of to the morgue.
GOLD: But the problem is that several of the tests that Stacey Riggs is getting are not recommended for healthy people who don't have symptoms. In fact, using the carotid artery screening test is even on the American Academy of Family Physicians' list of procedures to avoid. Dr. Glenn Stream chairs the Academy's board.
DR. GLENN STREAM: And what we're talking about with the carotid artery screening, is that person is more likely actually to have a stroke because they were screened, because of the subsequent testing and possible surgery, than if they'd never been screened at all.
GOLD: Up to 10 percent of the people screened by LifeLine are found to have some sort of abnormality. And the follow-up tests and treatments have risks of their own. Stream says once you find something, it's hard not to treat it, even when it's not the right thing to do.
STREAM: There's sort of a compelling momentum for patient and doctor both to say, well, now that we know there's a problem we need to further investigate and understand it. And then there's the dilemma about do we treat it or leave it alone? And, you know, so many times watchful waiting is the right treatment option, but it just doesn't always sit well.
GOLD: He says the research and advisory panels are pretty much unanimous: for people without symptoms or risk factors, several of the tests LifeLine and other companies like it offer are more likely to cause harm than good. But LifeLine's Dr. Manganaro counters that the research is out of date. And even for people who aren't at major risk, the tests push them to change their lifestyle before things get out of hand.
MANGANARO: If you show someone a picture of their carotid arteries filled with plaque as compared to a normal carotid artery, they are much more likely to throw out their Lucky Strikes on the way out the door.
GOLD: But it's not just about quitting smoking or taking other steps to improve your health. It's also about money. LifeLine is a for-profit company, and it often partners with local hospitals and surgical centers, which help advertise the event. And if Lifeline finds a problem, the patients can be referred to the hospital for follow-up care, which means new business for the hospital.
John Santa is medical director at Consumer Reports Health. He says the fact that for-profit companies are pushing these tests should raise consumer suspicions.
JOHN SANTA: When information comes in the form of an advertisement or promotion, be skeptical. Realize that if this was a really good and important thing to do, you probably wouldn't need to be advertising and promoting it.
GOLD: And most importantly, he says, talk to your family doctor before doing any kind of screening. For NPR News, I'm Jenny Gold.
MONTAGNE: And that report comes to us from Kaiser Health News, a nonprofit news service.
(SOUNDBITE OF MUSIC)
MONTAGNE: You're listening to MORNING EDITION, from NPR News.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.