Your doctor orders you a full-body CT scan, just to rule out anything serious. But do you need it? Read on to find out which unnecessary medical tests to avoid, and which you really should get...
Medical tests are modern marvels. They can uncover the body’s inner workings and reveal anything silently going wrong under the surface.
But before you spend valuable time and unnecessary money, check out our guide to 7 common tests:
1. Full-Body CT Scan
What is it? CT (computed tomography) scans use X-rays that a computer puts together for a detailed snapshot of your insides, like slices from a loaf of bread. It’s non-invasive and the actual scanning process takes less than 15 minutes.
Who’s it for? It’s an all-encompassing health test for nearly everyone. But such one-stop screening has downsides.
Some doctors believe full-body scans can find problems early, but they’re not recommended by most medical experts and associations, including the American Cancer Society, the Food and Drug Administration and the American College of Radiology.
“It's hard to find data that show a clear health benefit,” says Bibb Allen, M.D., a board-certified radiologist at Trinity Medical Center in Birmingham, Ala.
Pros and cons: The initial scan may be the first of many tests because it could find benign diseases that must be identified. This may lead to unnecessary biopsies – even surgery – to check out all the oddities a full-body scan uncovers, he says.
And if you have a scan this year, do you need a follow-up every year?
“You’re not sick today but what’s your window?” Allen asks.
There’s also the risk of getting zapped with three years worth of radiation (10 mSv) at one time. In comparison, we typically receive about 3 mSv per year from our surroundings – background radiation from space and radon gas – and .01 mSv of radiation from a chest X-ray.
What’s the cost? Insurance won’t cover full-body scans, so you’ll pay $600-$1,300 or more.
2. Genetic Testing
What is it? Genetic testing checks your DNA (with a mouth swab or blood draw) to see if you carry genetic markers for a disease, disorder or physical trait. Our genes can reveal the likelihood of getting breast cancer, diabetes, Alzheimer’s, even male-pattern baldness.
Who’s it for? Most tests are limited; they determine only your risk for a disorder or disease, such as breast cancer, compared to the normal population. In rare cases, such as Huntington’s disease, genetic testing can give yes-or-no results.
Some couples planning to have children may get tested for hereditary diseases, such as Tay-Sachs or sickle-cell anemia.
Pros and cons: These medical tests are painless, but the consequences may not be. Before you have one, ask what you would do with the results. Will it help in treatment? Would you have a preventive mastectomy? Would it affect your decision to have children?
What’s the cost? It varies widely, from $200 to several thousand dollars, depending on how common the test is and the type of analysis needed.
Insurance may cover DNA analysis, but it depends on the test, how reliable it is and what can be done with the information. Will your medical test results help with treatment or a cure?
Even if your insurance covers testing, you should weigh possible privacy and discrimination issues before you file a claim.
For example, would you want your insurance company to know you have a higher risk of getting breast cancer or diabetes?
For more information, read Genetic Testing: Does It Help or Hurt?
3. Bone-Density Scan
What is it? A bone-density scan checks for osteoporosis or susceptibility to the disorder, which is a weakening of the bones usually caused by aging. A scanner emits two X-ray beams – one high energy and one low – that pass through a bone, usually the spine or the hip. The difference between how the two beams go through the bone determines density.
Who’s it for? Radiologist Allen ranks bone-density scans up there with colon- and breast-cancer screenings.
Women are four times more likely than men to develop osteoporosis, so those older than 65 and younger postmenopausal women with other risk factors should request this medical test.
Besides menopause, risk factors include:
A history of fractures
Low body weight and stature
Cigarette smoking
A family history of fractures or osteoporosis
Inactive lifestyle
Alcohol use
Dementia
Rheumatoid arthritis
Use of certain medications, including steroids and birth control pills
Pros and cons: It’s non-invasive, takes only about 20 minutes and the amount of radiation is less than a chest X-ray. Downsides are few.
What’s the cost? About $200, and it’s covered by insurance.
4. Breast Ultrasound
What is it? Like a submarine’s sonar, an ultrasound uses sound waves to create a real-time picture inside your breast. As the technician moves a transducer (a microphone-like wand) coated with gel over the breast, you can see blood pulsing through your veins.
The ultrasound is looking for abnormalities – solid non-cancerous lumps of tissue or cancerous tumors or benign cysts.
Who’s it for? Breast ultrasound is recommended for women with dense breasts (and little fat). About half of women younger than 50 and a third of those older than 50 have dense breasts. The scan is recommended for those with abnormal mammograms and pregnant women because mammography radiation may be dangerous to the fetus.
Pros and cons: A breast ultrasound is non-invasive, costs less than most similar scans and doesn’t use ionizing radiation (as X-rays do).
In women with a higher risk for breast cancer – those with dense breasts or a close relative diagnosed with the disease before age 50 – ultrasound found 32% more cases than mammography, according to an article in the Journal of the American Medical Association.
But the study also reported that they also had higher false-positive rates – four times as many with as mammography – leading to unnecessary biopsies.
Ultrasound also can’t detect some early-stage breast cancers, such as calcifications.
Mammography is still the top choice of breast medical tests for women, but some women should discuss breast ultrasound as a primary or secondary screening tool with their doctor.
What’s the cost? Most are $200-$500.
Insurance often won't pay for a routine ultrasound, but it may if a physician orders one because of an abnormality in a mammogram.
5. Pelvic Ultrasound
What is it? Using sound waves to produce images, a pelvic ultrasound checks for tumors, urinary tract and bladder disorders, kidney stones and anomalies in the uterus, cervix, fallopian tubes and ovaries.
There are three types:
Transabdominal, where the transducer is passed over the abdomen
Transvaginal, where a specially shaped transducer is inserted into the vagina
Transrectal, where a transducer is put in the rectum
Who’s it for? Your doctor may order a pelvic ultrasound if you have unexplained bleeding, suspected fibroids or bladder problems. It can detect the source of the bleeding and fibroids, and check whether you’re completely emptying your bladder.
Pros and cons: It’s non-invasive, relatively fast and uses sound waves instead of X-rays. But bones or hollow organs, such as intestines, don’t show up well and may even obscure other organs.
What’s the cost? From $500-$1,500; it’s usually covered by insurance.
6. MRI
What is it? An MRI (magnetic resonance imaging) scan uses a magnet, radio waves and a computer to produce a detailed image of the body. The magnet is a hollow tube big enough for a prone patient to pass through.
If you're claustrophobic or weigh more than 300 pounds, doctors may use an “open” MRI scanner, with the magnet suspended by poles. But many medical experts feel the closed scanner yields much clearer images.
Who’s it for? MRIs diagnose cancer, spinal problems and heart disease, among other disorders. It’s also used for guiding needles during biopsies; giving information about joints, bones and soft tissue; and detecting brain activity (known as functional MRI or fMRI).
Pros and cons: MRIs are important medical tests because of their precision. They don’t use X-rays or other forms of radiation and they don’t pose any known risks.
Tell your doctor if you have any metal, such as surgical clips or bone plates, in your body, because the MRI magnet might shift them.
What's the cost? About $400 to more than $2,000; the average cost is $800. Insurance usually pays for it.
7. PET Scan
What is it? A PET (positron emission tomography) scan uses a small amount of radioactive material to make an image of your tissue or organs. You have to swallow, inhale or be injected with a radiotracer, which accumulates in the area being studied. The scanner measures the gamma rays from the radiotracer and a computer assembles the measurements into images. Unlike other scanning methods, PET scans can detect biochemical activity, so it can tell if a cancer is benign or malignant and the success of chemotherapy.
Who’s it for? PET scans are effective at screening for cancer and recurrence, as well as measuring treatment efficacy. They also can detect heart disease, epilepsy and brain abnormalities.
Pros and cons: It's painless and non-invasive, except for the prick if the radiotracer is injected. Medical test results can reveal details, such a metabolic changes, that other scans can’t.
PET scans involve a tiny amount of radiated material going into your body, but nuclear medicine has been around for more than 50 years with no reported long-term effects.
What’s the cost? From $850-$4,000. Insurance often covers it, depending on the reason for the test.
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