By Dr. Anthony Policastro
There are a lot of medical preventive tests that make logical sense. That is why we do so many screening procedures. They have been shown to pick up some diseases at an early stage when treatment can be most beneficial.
Most of our cancer screening procedures fall into this category. Annual blood tests to look at blood sugar and cholesterol are also examples.
However, as medicine has gotten more sophisticated, there are some tests that can be beneficial, but also can only produce those benefits at certain ages.
An example of this is related to total body MRI scans. The companies that do them advertise the ability to pick up unexpected findings before symptoms occur. That can be beneficial.
What they do not advertise is who benefits the most from such tests. The answer is that it varies with the age of the individual.
For example, doing a full body MRI under the age of 40 years is unlikely to pick up unexpected findings. As a matter of fact, it is more likely that they will pick up something that is not abnormal enough to be an issue.
The term “incidentalomas” is sometimes used. That means it is just an incidental finding of no significance. The problem is that it still gets a medical workup done. There might be unnecessary further testing. There might be unnecessary biopsies. There is usually a lot of anxiety.
Therefore, in the under 40 age group, total body MRI testing is not that great an idea. The main exception would be in those individuals who are at high risk because of genetic factors or family history.
For seniors, the rate of finding abnormalities is increased. However, so is the rate of incidentalomas. The danger in this group is their underlying health issues. Since the likelihood of finding incidentalomas is higher, so is the likelihood of additional testing.
That kind of testing is what is known as the “cascade effect”. One leads to another and then another, etc. That testing can cause additional complications in someone who also has other medical issues. The risk may be too high to bother with the testing in the first place.
This leaves the group between the ages of 40 and 60. If anyone is a candidate for full body MRI’s, they are the potential target group. Scans may show an early cancer. They may show an aneurysm developing. They may show findings consistent with a chronic disease.
The current recommendations from most medical groups is that such MRI scans do not lead to enough findings to warrant their routine use.
However, there are some companies that offer them to anyone who is willing to pay for the testing. For example, one company has three levels of plans. Their “Core” membership costs $1,199 annually. That gets an MRI that covers the area from the head to the mid-thigh. It also covers basic blood tests.
Their “Comprehensive” membership costs $2,499 annually. This gets a whole body MRI scan and a more detailed set of blood tests.
Their “Executive” plan costs $4,499 annually. It includes the whole body MRI scan. It also includes “brain health assessment,” “body composition analysis” and an “extra-detailed” set of blood tests.
That means if you are between the ages of 40 and 60 and can afford the costs, you can choose to go above and beyond the basic history, physical and lab work that are currently done by your primary care physician.
However, the company that offers all this testing makes it clear that what they do does not replace the evaluation that takes place from you primary care physician. It is only a supplement to that all-important visit.