Charlize Du Preez outlines the drawbacks of the rise in unnecessary and underregulated healthcare available to consumers.
Preventative healthcare is an approach to health that aims to prevent conditions in the first place or manage them early before they cause problems. Examples include vaccinations, regular check-ups where your blood pressure and other measurements are taken, and cancer screening.
Preventative healthcare plays a vital role in the healthcare system and in improving the population's health. High blood pressure is one example of where preventative health is incredibly beneficial. High blood pressure is the most important risk factor for stroke and contributes to the development of many other conditions, such as heart and kidney disease. Thus, being aware of it and taking measures to manage it early on, starting with lifestyle changes, is important to decrease the chance of later problems.
While Preventative healthcare is essential, everything has drawbacks, and there is such a thing as too much. In recent years, there has been a boom in purchasable tests, from in-depth health check-ups to genetic screening.
Direct-to-consumer genetic testing has gained significant interest, with sites such as 23andMe offering tests for multiple diseases and other genetic markers. There are some benefits to this, such as greater awareness of your health and the opportunity to be proactive in adopting a healthy lifestyle. However, there are also risks and unintended consequences. Genetic testing can have far-reaching effects, affecting not only you but also your family. This is why genetic counselling is provided when formal, medically indicated genetic testing is performed, to educate you about the implications and meaning of the results. These tests also cannot conclusively say whether you will develop the disease, and often test only a select few genes for conditions that are polygenic, meaning multiple genes influence the development of the disease.
An example is the ApoE genes. ApoE2 is associated with a lower risk of Alzheimer's disease. In contrast, ApoE4 is associated with an increased risk, but just having these genes does not mean you will or will not develop Alzheimer's disease. Additionally, more than just genetics play a role in the development of polygenic disease; factors like your lifestyle and environment also matter. There are also other potential problems with direct-to-consumer testing regarding their genetic information. There is a risk that this data will be used for different purposes or even stolen if security is inadequate.
Medical tests can cause undue stress and anxiety due to false positives or unexpected results, and occasionally can lead to unnecessary, expensive, and time-consuming testing and treatment.
The Prostate-Specific Antigen (PSA) test is an example of a test that has both benefits and drawbacks. The PSA test is a useful test and can be used to test for the presence of prostate cancer early on and is used along with a physical examination to test for prostate cancer in people who have symptoms. However, the test is not specific for prostate cancer, and many men have been either falsely diagnosed or diagnosed when the tumor was small and may not have affected them in their lifetime, and thus unnecessarily undergo testing and treatment. This is why the PSA test is not used to screen for prostate cancer in men without symptoms.
In a healthcare system with limited resources, tests need to be justified. Ordering unnecessary tests can divert time and resources from people who need them and have been waiting a long time to receive them.
While preventative healthcare is essential for early detection and improving health, it is crucial to approach testing thoughtfully. Over-testing can lead to unnecessary stress, overtreatment, and misuse of limited healthcare resources. Balancing proactive health management with the responsible use of tests ensures that preventative care remains effective and accessible to everyone.