By Peter C. Gøtzsche at Brownstone dot org.

General health checks, called annual physicals in the United States, are sold to the public under false pretenses with claims that aren't true.

This also applies to targeted health checks, and mammography screening is a good example. Women have been told for 40 years in invitations to screening that by detecting breast cancers early, screening saves lives and leads to less invasive surgery. The truth is that breast screening detects cancers very late, it doesn't save lives, and more women lose a breast.

Mammography screening is harmful and general health checks are also harmful. Like breast screening, they detect many things that should not have been treated because they are either insignificant or will disappear again. In contrast to cars, our body has a remarkable capacity for self-healing.

Our Review of General Health Checks

Health checks can result in large bills for no gain just like car checks can. I never send my car to the annual car check, which has saved me an enormous amount of money. I only see a mechanic when there is something wrong with my car or for simple issues such as changing oil. I have the same relationship with my doctor.

Once, when I was on holiday on Maui, I passed a booth where people could have their blood pressure checked. Just for the fun of it, I stretched my arm out. "What is your usual blood pressure," a woman asked. "I have no idea," I replied, which made her laugh in disbelief. I was 58 years old and fit, and the few times in my life that someone had taken my blood pressure during a hospital admission, it had been low, so why should I bother about that? I couldn't help provoking her a little and therefore told her I had no idea either of what my cholesterol was. At that point, she asked me which country I came from!

In Denmark, the doctors were sceptical towards general health checks, but in 2007, the Danish Association of the Pharmaceutical Industry convinced the politicians to introduce them, even though an industry spokesperson admitted that their goal was to sell more drugs.

Nothing happened, however. But in 2011, our new government wanted to introduce general health checks. I asked to have a meeting with the Minister of Health, Astrid Krag, because our review of the randomised trials, which we had just completed but not yet published, had found no effect on mortality. I brought a colleague to the meeting who had just finished a large trial in Denmark, which had also failed to find an effect.

We told Krag that health checks are probably harmful, leading to more diagnoses, more drugs, and psychological problems because people are told they are less healthy than they think. She aborted her plans on the spot and said it was the first time the new government had broken a pre-election promise in an evidence-based manner.

We had included 14 trials in adults unselected for diseases or risk factors. We published our review in 2012 and updated it in 2019. There was no reduction in total mortality (risk ratio 1.00), cardiovascular mortality (risk ratio 1.05), or cancer mortality (risk ratio 1.01), and with 21,535 deaths, our results were very convincing.

There were no benefits either for clinical events, hospital admissions, or other measures of morbidity, but there were harms. More people got a disease label and more became treated with antihypertensive drugs. We concluded cautiously that general health checks are unlikely to be beneficial, but in fact they are harmful.

We had also studied 56 Danish websites selling health checks and found that 17 of the 21 most-used tests were unjustified or there was evidence against using them for screening purposes. None of the websites mentioned any harms of health checks and they presented a median of only one of the 15 information items recommended by the WHO and the Danish Board of Health when screening healthy people. Thus, there was no informed consent.

Our review saved billions of crowns for Danish taxpayers...