Can routine physical examination detect cancer

The answer is that some common cancers can be detected by routine physical examination, but it cannot cover all cancer types, nor can it achieve 100% early screening accuracy. There is no need to overly deify it, and there is no need to completely deny its role.

I have been doing health management in a physical examination center for almost 6 years, and I have come across many examples of early-stage cancers detected through routine physical examinations: Last year, there was a 52-year-old veteran employee of a state-owned enterprise who received the basic package every year from his company. This time, a chest X-ray showed a small nodule with ill-defined boundaries in his left lung. We urged him to undergo further puncture and it was confirmed that it was very early-stage lung adenocarcinoma. The lesion was only 0.8cm. After the operation, he did not even need auxiliary treatment. Now he can go to the park for a walk every day. The same group of physical examination workers in the unit and two aunts detected early-stage breast cancer through routine breast palpation and B-ultrasound, and the prognosis was particularly good.

Of course, I often encounter people complaining that "I have a physical examination every year, and it turns out that I have terminal cancer." In this case, it is not that the physical examination is useless, but it is probably because they have not chosen the right items to match them. For example, a 39-year-old woman who came for consultation last month had a basic physical examination at work half a year ago, which was all normal. However, she was recently diagnosed with stage III ovarian cancer due to abdominal distension. The resolution of the abdominal B-ultrasound during the routine physical examination was not high enough and small lesions deep in the pelvic cavity could not be seen at all. The tumor marker CA125 and vaginal ultrasound were not included in her package, so they were naturally missed. There are also cancers such as pancreatic cancer and bile duct cancer that are particularly deep-seated and have almost no specific symptoms in the early stages. Routine physical examination items are basically unavailable and are indeed difficult to detect.

The industry has been debating whether to add more cancer screening items to routine physical examinations. Opponents believe that routine physical examinations are universal examinations for ordinary healthy people. If PET-CT and painless gastrointestinal endoscopy are included in the basic package, the price will increase several times, and many working-class people cannot afford it. Moreover, doing radiation-related projects every year will increase health risks. We cannot let everyone undergo excessive examinations just to screen for rare cancers with extremely low incidence. Those who support it believe that now that cancers are more and more likely to occur at younger ages, adding a few low-cost screening items, such as low-dose spiral CT for people over 40 years old, and HPV and TCT for women of the right age, can increase the early diagnosis rate of high-incidence cancers, and the cost-effectiveness is actually very high.

To be honest, a routine physical examination is like a routine cleaning for the body. It can sweep out the garbage on the desktop and the floor (early signs of high-incidence cancers such as lung cancer, breast cancer, and cervical cancer). If you want to clean up the dust accumulated under the bed and in the corners (pancreatic cancer, egg For cancers that are highly insidious, such as nest cancer), you have to add targeted items based on your family history and living habits. For example, if you smoke all year round, you can have more low-dose spiral CT. If you have a family history of gastric cancer, you can have a gastrointestinal endoscopy every two or three years. It is much more useful than blindly pursuing expensive physical examination packages.