Health check packages in India

What is actually worth testing

These are the checks that reliably find problems early enough to change the outcome, and most of them are cheap and unglamorous.

• Blood pressure. Causes no symptoms and causes strokes, heart failure and kidney damage. The single highest-value measurement in medicine, and it takes a minute.
• Blood sugar and HbA1c. Type 2 diabetes is frequently present for years before diagnosis, doing damage throughout. Finding it early genuinely changes the course.
• Cholesterol and lipid profile. Combined with blood pressure, age and smoking, this is what estimates your cardiovascular risk and decides whether treatment is worthwhile.
• Kidney function and urine protein. Kidney disease is silent until late. Protein in the urine is an early signal, particularly with diabetes or high blood pressure.
• Liver function. Picks up fatty liver, hepatitis and alcohol-related damage while they are still reversible.
• Full blood count. Detects anaemia, which is common and frequently has a cause worth finding.
• Thyroid function. Common, easily treated, and often missed because the symptoms are vague.
• Retinal examination if you have diabetes. See eye surgery in India. This one prevents blindness.

Cancer screening, by age and risk

Screening tests are different from diagnostic tests: they look for disease in people without symptoms, and only a few have been shown to save lives.

• Cervical screening for women, by smear or HPV testing. Highly effective, and cervical cancer is largely preventable through it. See cervical cancer.
• Breast screening by mammography from the recommended age, or earlier with a strong family history. See breast cancer.
• Bowel screening, by stool testing or colonoscopy from the recommended age, and earlier with a family history. See colorectal cancer.
• Discussion about PSA for men, rather than automatic testing, because the trade-offs are genuinely balanced. See prostate cancer.
• Hepatitis B and C testing, which is worthwhile in many of the regions our patients come from, because both are treatable and both are silent for years.

What is usually not worth doing

Health check packages are a commercial product, and the more tests a package contains the more impressive it looks. But every test in someone without symptoms carries a chance of a false positive, and a false positive leads to more tests, sometimes invasive ones, and to months of anxiety. More is not better.

• Tumour marker panels in healthy people. Markers such as CA-125 and CEA are useful for following a known cancer. Used as screening in someone with no symptoms they produce far more false alarms than diagnoses.
• Whole-body CT or PET screening. Significant radiation, and a high rate of incidental findings that require investigation and almost always turn out to be nothing.
• Routine ECG and stress testing in people with no symptoms and no risk factors. Poor at predicting events and prone to false positives that lead to angiograms.
• Very long vitamin and hormone panels ordered without a clinical reason.

This is not an argument against having a check. It is an argument for having the right one, and for asking of any test in a package: what would we do differently depending on the result? If there is no good answer, the test is decoration.

The best time to have one

If you are already travelling to India for treatment, or accompanying a family member who is, a health check is unusually good value: you are already there, the accommodation is already paid for, and the marginal cost is small.

This applies particularly to accompanying family members, who are often in the country for weeks with nothing to do, and who frequently have untreated high blood pressure or undiagnosed diabetes of their own. Several of the most useful findings we hear about come from the person who came along as the attendant.

A check is only useful if someone acts on it

The failure mode of health checks done abroad is a folder of results that nobody at home ever reads. Before you leave, make sure you have the results in writing with the abnormal values clearly flagged, a written explanation of what each abnormal result means and what should happen next, and any prescription with the generic drug names rather than only Indian brand names, so a pharmacist at home can dispense the equivalent.

Then make an appointment with a doctor where you live, and hand the folder over. That step is what turns a check into a benefit.

Related

• Scans and tests in India
• Diabetes, thyroid and endocrine care
• Eye surgery in India
• All treatments in India