Medicandus

Medicandus

Make your New Year’s health resolution about prevention. That’s where the big gains are

At a time of year when we are flooded with advertisements for detox and weight loss products, I’ve been doing some detoxing of my own. Specifically, a day of fasting and bowel preparation for my colonscopy tomorrow. At the risk of oversharing, I think it’s fair to say I can regard myself as pretty well cleansed right at the minute.

I’m a little overdue for my scope, as I should have had my first one a couple of years ago, according to the best available guidelines for my risk. My risk is high for polyps as my uncle died in his 50s from colorectal cancer and my mum had a polyp found at her screening colonoscopy which had just turned nasty. That was 20 years or so ago and there has been no recurrence, so I don’t need much convincing about the benefits of early detection.

For most people though, an invasive procedure like a scope isn’t necessary. If you are of average risk background, a faecal occult blood test (FOBT) is worth doing once you are past the age of 50. The test is available through the National Bowel Cancer Screening Program and is non-invasive, though slightly icky.

Evidence-based screening for diseases is becoming increasingly challenging in today’s environment where health consumers are bombarded from all sides by information about health risks and prevention. The Daily Mail in the UK is emblematic of the tabloid media’s almost comical obsession with mangling the reporting of cancer risk. This sort of mindless scaremongering has been satirised memorably in song by comedian Russell Howard.

Australian health professionals have the magnificent resource of the RACGP Red Book to guide them in recommending ways to systematically prevent disease. This is one of those “bibles” of scientific medicine which I think are among the glories of my profession. They are made freely available without glitz or marketing but they are the result of hundreds if not thousands of hours of pro bono work by experts in various relevant disciplines. Such works are dynamic, and are constantly revised as new techniques of screening are introduced and re-evaluated for risk and benefit. When you ask your GP what (if any) screening tests you need, that’s where the answer should come from, and it will be the distillation of all that expertise.

Prevention of ill health (not just cancer) pays off so well economically and socially it’s hard to imagine a better way to spend health resources. You can work longer, retire on your own terms, enjoy more time with your family and friends and avoid the merry-go-round of appointments or admissions that is inevitable with chronic poor health. You can’t help bad luck but you can be ready so you cope better with it.

New Year’s resolutions are often to do with health goals, and you can certainly tell this from the number of TV and internet ads for dodgy detoxes and fad weight-loss products. I’d encourage you (if you are really serious about getting yourself right) to click this link to the Red Book chart that summarises everything you should be concentrating on and find yourself a couple of projects to discuss with your GP.

Make 2015 the year you ignore the moronic fads and follow through with what you should really be doing to prevent ill health. Eat less, and better. Exercise safely and more often. Drink a fair bit less and don’t smoke at all.

Get your screening tests as they are due. Don’t sook about them; they’re more important than the transient discomfort or other unpleasantness they may involve. Having a healthier old age where you will be much less likely to meet people like me is just the beginning of the reward.