Medical student Jinken Li discusses the pros and cons of the current lifestyle trend for full-body scans.
As a medical student, it’s ironic that I don’t have the healthiest lifestyle. Be it sleeping in on weekends, or a woefully unvaried diet, these are aspects of healthy living – diet and exercise – that are well-known to have a major effect on an individual’s wellbeing. But in an increasingly health-conscious society, people want to take that extra step towards ensuring the longevity of their health.
This is where the development of technology and the profit motive have resulted in the trend for full-body scans, offered by private companies such as Prenuvo. These scans capitalise human curiosity and the natural fear of uncertainty we all share. What if there is a developing disease inside me right now? What if the cough I have right now is lung cancer? These are concerns that full-body scans seek to alleviate, for a cost roughly between 1000 to 2000 pounds.
Full-body scans offer a compelling deal to consumers who want comprehensive disease screening. For example, Prenuvo scans look for more than 500 conditions, allowing for early detection that can be particularly beneficial for conditions such as cancer or heart disease, where treatment can be administered long before any symptoms arise. Companies often emphasise the fast-developing nature of certain diseases and the benefits of early intervention. These scans can detect slowly developing conditions like spine degradation or arterial narrowing, allowing recommendations specific to each patient. They also satisfy the curiosity of wanting to know what’s going on inside your body, and so a sense of security is afforded to people knowing that they are healthy.
So why not get a full-body scan?
The most obvious issue is cost. In Kim Kardashian’s Instagram post promoting full-body scans from Prenuvo, many comments highlighted the privileged and ‘out of touch’ nature of the post. Especially in a cost of living crisis, these extremely expensive scans simply remain inaccessible to many. However, the issues extend far beyond an individual’s financial capability to pay for the test. Even if these scans were free, there are still risks that cast doubt on any proposed benefit.
If we first think about who the target demographic is for these tests – generally healthy, rich and middle-aged individuals – the prevalence of disease will be so low that any inaccuracies in testing are amplified, and so false positives and false negatives become a large problem. This causes unwarranted panic in the case of false positives, or a false sense of security, where genuinely concerning symptoms are ignored due to a reassuring full-body scan report.
This problem is one of the reasons why the history and physical examination of patient is so important. Doctors are trying to deduce a diagnosis that is most likely for the certain symptoms and risk factors that a patient presents with, and tests are used to confirm this diagnosis. Without establishing a strong pre-test probability, any positive result will likely be inconclusive.
Even considering the general lack of symptoms or risk factors, due to the inherent nature of these tests, it will be rare to find absolutely no problems. Think about your bumps, scratches or blemishes – everyone has abnormalities with their bodies. The issue with professionals actively looking for problems in healthy individuals is that every finding is an incidental finding. With no symptoms, incidental findings will be harmless in the vast majority of instances, but when they get flagged up in these tests people often plunge into a chain reaction of care, where more tests and treatments are administered.
This phenomenon is well recognised as over-diagnosis, and the benefit of these scans come into question when you consider the very real risks of surgical complications, the side effects of medicines, the psychological burden on individuals, or the strain on the NHS health system in treating these incidental findings.
I would say full-body scans are analogous to a lottery ticket. There is no doubt about the inspirational stories of stopping a life-threatening disease in its tracks, but most people do not derive any benefit – if anything, they may find themselves locked in a room filled with doctors. If people are genuinely concerned about their health, a GP consultation would prove far more effective than any full-body scan.
In Kim Kardashian’s post, many comments were quick to assume that these scans were vital to their health. But when I think about the walking I do every day, or the fruits and vegetables I eat, these are the actions that truly have lifesaving potential.
