Before saying yes to the medical test, know the risks and benefits

Before undergoing a medical test, it is crucial to understand both the potential benefits and risks involved. While some medical tests, such as full-body MRI scans, are promoted by companies to detect cancer and other diseases early, major medical associations like the American Cancer Society and the American College of Radiology do not recommend these scans for people without a very high risk of certain cancers.

It's important to note that many tests marketed directly to consumers, including full-body scans and at-home blood screening kits, are not covered by insurance and can cost several thousand dollars. Some laboratory tests may only involve discomfort from a blood draw or collecting a urine or stool sample, but others can pose a risk of physical harm.

For instance, a small percentage of people who undergo CT scans each year may develop cancer due to radiation exposure. Invasive procedures like biopsies or endoscopies can lead to pain, infections, tearing, anesthesia reactions, or even more serious complications. Additionally, testing can cause anxiety and stress as patients await results and worry about inconclusive findings.

One alarming consequence of medical testing is a diagnostic cascade, where results often lead to additional, potentially more invasive testing. In a notable case documented in JAMA Internal Medicine in 2011, a 52-year-old woman experienced chest pain and initially had her doctor reassured that her pain was muscular with a low risk for heart disease. However, her doctor ordered a heart scan out of caution, which led to further tests and ultimately required emergency bypass surgery and even a heart transplant.

Before consenting to a medical test, it is essential to consider the risks and benefits. Patients should ask their medical provider and themselves questions like whether the test is necessary, what the potential benefits are, and whether the results could lead to further invasive procedures. It's worth remembering that many test results, particularly in cardiology, often point patients back to basic healthy lifestyle choices such as eating well, exercising, and avoiding smoking. These lifestyle changes can be advised without the need for a test.

If your health insurance covers a medical test, it means the test has likely met scientific standards vetted by organizations like the U.S. Preventive Services Task Force, which rates services as A or B in terms of evidence-based benefits. However, many medical tests marketed directly to consumers are not covered by insurance, emphasizing the importance of understanding the associated costs and risks.