Most major health organizations, including the U.S. Preventive Service Task Force and the American Medical Association, no longer recommend standardized annual physical exams for most healthy adults. In 1996, the U.S. Preventive Service Task Force began recommending periodic health exams based on individual risk factors for disease. The task force confirmed that routine screenings for high blood pressure and cervical cancer, as well as age-appropriate screenings for colorectal and breast cancer were beneficial. However, they do not recommend routine PSA testing for prostate cancer detection, routine blood tests for diabetes, thyroid disease, or anemia, routine x-rays, routine ECGs, or routine urine tests.
In spite of the recommendations of major health groups, many doctors and their patients believe that annual physical exams are beneficial. One study, published in Archives of Internal Medicine, surveyed about 800 primary care providers (PCPs) about annual exams. They found that approximately 9 out of 10 doctors reported performing annual exams.
"Despite contrary evidence, most PCPs believe an annual physical examination detects subclinical illness, and many report performing unproven screening laboratory tests," the study authors write. "Primary care providers do not appear to accept recommendations that annual physical examinations be abandoned in favor of a more selective approach to preventing health problems."
According to the University of Maryland Medical Center, the following physical exam guidelines are recommended:
1. Adults should have two physical exams in their 20s.
2. Adults ages 40 to 65 should have a physical exam every 1 to 5 years.
3. Men over the age of 50 should have a yearly rectal exam to screen for colorectal cancer and prostate cancer.
4. Adults over the age of 65 should have a yearly physical exam and their hearing tested.
5. All women should have a yearly pelvic exam and Pap smear performed. If Pap smears are negative for 3 years in a row, a Pap smear should be done every 2-3 years.
6. Women over the age of 40 should have a mammogram done yearly to screen for breast cancer.
7. All adults should go to the dentist every year for an exam and cleaning.
8. All adults with vision problems should have an eye exam every 2 years.
9. All adults should have their blood pressure checked every year.
REFERENCES:
1. Prochazka AV et al. Support of evidence-based guidelines for the annual physical examination: a survey of primary care providers. Arch Intern Med 2006 Feb 13;166(3):368.
2. Boyles S. Doctors Still Support Annual Exams, WebMD, June 27, 2005.
http://www.webmd.com/content/Article/107/108705.htm
3. Boyles S. Do You Need an Annual Physical? WebMD, May 8, 2002.
http://www.webmd.com/content/Article/16/1685_53172.htm
4. Physical Exam Frequency, University of Maryland Medical Center, Ummedu:
http://www.umm.edu/ency/article/002125.htm
Posted by Elaine Gavalas on August 20, 2006 02:44 PM
