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i wanted to buy only the 1,688 yuan middle-aged and elderly package, but i ended up adding 4 items, which cost more than 4,000 yuan.

are additional physical examination items that address health anxiety "useless" or just a necessity?

"when i was shopping online, i was reminded that i could add items. the original 1,688 yuan package for the middle-aged and elderly was charged more than 4,000 yuan with the addition of five thyroid function tests, bone density, liver cancer risk assessment, and alzheimer's disease testing." on august 13, mr. zhou from foshan, guangdong, told reporters about the doubts he encountered when shopping for a medical checkup package for his mother recently:why are the physical examination items promoted by institutions always able to accurately address people’s health anxieties, and why are there more and more high-cost physical examination items?

the purpose of a physical examination is to understand one's own health status. however, according to interviews with the workers' daily, many people have encountered such situations during physical examinations: the institution strongly persuades them to add some examination items with miraculous diagnostic and therapeutic effects, some of which cost thousands of yuan. due to lack of relevant examination knowledge or concern for their own and their family's health, some people eventually purchased these items, but the result was not a satisfactory examination experience.

“necessary and urgent” additional medical examination items

when mr. zhou took his nearly 60-year-old mother to a certain institution for a physical examination, he specifically chose the middle-aged and elderly female physical examination package, which included 35 items such as general examination, internal medicine, female surgery, and gynecology. after entering the reservation process, mr. zhou found that the selection was not over, and there were many additional items on the page, and it seemed that every item needed to be done.

"last year, my mother's physical examination report showed that the echo of her thyroid gland was uneven. when helping to interpret the report, the staff of the physical examination institution recommended adding thyroid function tests and tracking the condition of the thyroid gland every year." thinking of this, mr. zhou immediately checked the five-item thyroid function test which cost 312 yuan.

on the additional item page shown by mr. zhou, the reporter saw that under the cardiovascular and cerebrovascular depth detection item, it was written: "there are about 2 million new cases of stroke in my country every year, which seriously threatens the health of the chinese people"; the lung depth detection item was written: "the incidence of lung cancer ranks first among malignant tumors, and the number of lung cancer deaths in my country reaches 587,000 each year"; the diabetes screening item was written: "china is one of the countries with the fastest growth in the number of diabetes patients in the world"...

mr. zhou said that these notes made him feel that each additional item in the physical examination was very necessary and urgent. therefore, he added several items such as liver cancer risk assessment for his mother.

in fact, this kind of emphasis on the "necessity and urgency" of physical examination items often runs through the entire physical examination. ms. guo from changping district, beijing, had a physical examination at the end of july. she told reporters that from the time she checked in and waited for the examination, to the specific item testing, to receiving the physical examination report, the staff of the physical examination institution always recommended additional items to her.

"when i checked in at the front desk, the staff asked if we wanted to add special screening items such as liver cancer and gastrointestinal cancer." ms. guo recalled that when she received the blood collection tube in the blood drawing room, the staff also quickly promoted some testing items and emphasized that they could screen for cancer and prevent it in advance. according to her observation, once the examinee agrees to add an item, the staff will immediately add a vacuum tube and remind him to check out at the front desk after the examination.

there are many high-priced items on the add-on page

in addition to using patient data to make people anxious and make them feel "must get checked and cannot be missed", some medical examination institutions promote additional medical examination items that have "complex names, advanced technologies, and powerful effects" and are not cheap.

mr. zhou said that he saw many high-priced physical examination items on the add-on page. for example, the liver cancer screening project, which claims to be able to detect with a small amount of blood, costs about 4,000 yuan; the early screening project for colorectal cancer through fecal examination costs nearly 1,600 yuan; the three microrna tests for alzheimer's disease cost about 1,400 yuan, etc. in addition, there is a cellular immunity test for people with chronic diseases and sub-health, which costs more than 500 yuan.

are the extra items that are being sold necessary? are the high-priced examination items trustworthy? recently, mr. wang from xi'an, shaanxi, had some additional items added to his physical examination at the persuasion of the staff. "i chose the young and middle-aged male package, which includes prostate color doppler ultrasound. when i checked in at the front desk, they suggested adding a prostate tumor marker test, which costs about 200 yuan and can increase the positive diagnosis rate."

after receiving the physical examination report, mr. wang saw that his prostate tumor marker index was abnormal, so he urgently went to the hospital's urology department to register and spent more than 700 yuan on a prostate mri. the doctor reviewed mr. wang's mri report in conjunction with the consultation and said that there was nothing wrong. it might be that the tumor marker index was abnormal due to prostate hyperplasia. just pay more attention and have regular tests. afterwards, mr. wang felt that he had spent nearly a thousand yuan to "buy peace of mind."

in response to mr. wang's situation, zheng kai, deputy chief physician of the department of cardiothoracic surgery at tianjin medical university general hospital, pointed out that tumors in different tissues and organs have different types of metabolites due to different cell types, so tumor marker tests are actually a bit "useless" as a screening project. however, for patients who have been diagnosed or have imaging tests to support tumor problems, this test is very meaningful.

are the more and more comprehensive the physical examination items, the better? you should choose carefully based on your understanding.

feng xiang, director of the health management center of henan provincial workers' hospital, told the workers' daily that some private medical examination institutions set the price of basic medical examinations very low, and the examinees only found out that some additional examination items were required when they arrived at the site. each additional item may have a certain risk screening function, but most people do not need many of them.

feng xiang introduced that when public institutions recommend additional items, they usually use self-test questionnaires to understand the family medical history, lifestyle, and living habits of the examinee, and doctors judge whether there is a health risk based on this. another situation is that after the basic examination results come out, it is determined that additional items are needed. even if additional items are needed, they are not blindly recommended, but emphasize in-depth examination.

"physical examination items generally do not cause harm to the health of the examinees, so some physical examination institutions hope that the examinees will have as many examination items as possible, but the institutions should also consider making sure that the examinees' money is spent wisely," said feng xiang.

zheng kai also believes that when routine examinations cannot meet the needs, it is understandable to choose additional items appropriately. in addition, the public's requirements for physical examinations are getting higher and higher, hoping to detect diseases earlier and intervene in treatment as soon as possible.

"objectively speaking, all kinds of physical examination items have their own significance. the most important thing is to determine whether they are suitable for you. this requires a specific analysis based on age, gender, family situation, previous illness, occupational status, etc." zheng kai emphasized that various physical examination items should not be deified and should be chosen after clearly understanding one's own body.

reporter liu xiaoyan