Screening information

Why screening?

The primary purpose of screening (also called ‘preventive examination’) is to trace an illness in the early stage, so effective measures can be taken in time.

As a rule, illnesses are easier to treat if they are discovered in the early stage. Screening is done when people without complaints undergo an examination to find out whether they might have an early. A good example of early detection is the population screening for breast cancer, in which every woman over 50 years of age is examined on a regular basis. This examination is generally known, but is limited to the breasts only.

A body scan gives insight into the vital parts of your body. During this examination, it is standard that the vital organs and blood vessels are examined by an MRI (magnetic resonance imaging) and we include a cardiac screening to look at your heart.

Our MRI consists of a four-part scan that includes the skull and brain, arteries of the neck, upper abdomen and lower abdomen. We would only see an overview of the lumbar spine (lower back), since the focus of the MRI scan as part of the body scan is on the organs and arteries and not on the joints.

In the areas we examine with an MRI scanner there is much to be diagnosed. Some organs, such as the stomach and intestines, do not always give a clear picture. A supplementary examination is required to be able to give a good diagnosis of the stomach and intestinal tract. For more information about organs that can be diagnosed less specifically, refer to the section 'supplementary examinations and other important information'.

On basis of risk factors the doctor may give advice during the first consultation to make some changes in the standard examination programme.

MRI

The latest developments in the field of magnetic resonance imaging and CT-scanning make it possible to examine larger parts of the body or even the complete body. Current relevant scientific examinations have shown that an MRI-scan has absolutely no side effects, making this type of scan the most suitable for screening. An MRI scan uses harmless magnetic fields instead of X-radiation.

In certain clinics, a contrast agent is used during the examination, to obtain an even clearer picture. This is administered by means of an infusion in your arm. This special MRI contrast fluid is currently used a lot. Side effects (such as skin allergies) are rare and serious reactions to contrast fluid are very rare (approximately 1: 8000000). It is important not to compare MRI contrast agent with the dangerous X-ray contrast medium. Because contrast fluid is excreted via the kidneys, no contrast fluid will be used if you have a serious renal dysfunction.

Supplementary examinations and other important information

CT-scan of heart and lungs

Because a CT scan uses X-rays (although the scans are carried out with an extremely low dose), the doctors set a limit of two very important organs; the heart and lungs. The CT scan will only be carried out if certain risk factors are present. A CT scan of the heart detects, the calcified plaques responsible for any clogging of the coronary arteries. This examination has a risk indication of a heart infarct in the oncoming 5-10 years. The CT scan of the heart can be carried out if one is older than 40 years and there are risk factors present such as high blood pressure, high cholesterol, overweight, diabetes, illnesses in the family and/or smoking.

The second examination is the CT-scan of the lungs. Recent research results have shown that the number of deaths among smokers decreases strongly if one undergoes a CT scan each year. 80% survived instead of the normal 20%. To participate in this research certain requirements must be met. One must be over the age 40 years and have smoked at least 20 cigarettes per day for more than 20 years. If one has stopped, it is advisable to be scanned up to 15 years from the time you stopped smoking. A CT scan of the lungs can also be performed when one has persistent lung complaints, such as coughing, airway complaints, coughing up blood, a hereditary lung disorder(s) and when there has been exposure to asbestos in the past. If one does not meet the criteria for a CT scan of the lungs, it is possible to get an MRI scan of the lungs.

Breast examination

Breast examinations are not a standard part of the body scan and there are several reasons for this. First, women in the UK above the age of 50 years are screened for breast cancer every two years. As breast diagnostics are very precise, the strength of this examination is in the comparison of current images to previous images. Time has shown that undergoing a mammography once only, does not provide a reliable diagnosis. Also, a mammography emits X-rays and our radiologists want to limit X-rays as much as possible to protect your body. Purely making an MRI scan of the breasts at the moment gives such a high percentage of error-positive results, that the MRI scan for clients without symptoms/heredity does not have preference. A mammography in combination with an ultrasound or MRI of the breasts is still the most reliable (and most cost-effective). It is possible to have a supplementary examination of the breasts at most clinics we work with. After studying the risk factors, such as heredity and complaints, the doctor will, in consultation with you, determine which examination is best for you. The doctors will be somewhat careful with the use of X-rays and it may be that initially only a tactile examination and ultra sound will be done.

Stomach and gastro intestinal tract (including the oesophagus)

The gastro intestinal tract (including the oesophagus) can best be examined internally by means of so-called endoscope (a flexible tube with light and camera). The MRI scan is not suitable for this. Tumours can be concealed in mucus, may be confused with faeces or other irregularities and the intestine is moving continuously. To detect possible tumours in this tract, the most commonly used method of examination is the gastro- or colonoscopy. This viewing technique gives immediate sight into the inner side of the intestines and can take small tissue samples and/or remove polyps for further examination. In our body scan a stool test is done to detect whether there is is blood in the faeces. This examination is somewhat less reliable, but it is an alternative for people who do not want a gastro-intestinal examination.

Throat area (including the larynx and vocal cords)

This requires internal inspection by an ENT doctor using a so-called laryngoscope, (a thin flexible fibre scope), the most reliable examination method. The MRI scan is not suitable for this. Prescan does not offer this examination.

Thyroid

The echo technique, laboratory tests, scintigraphy and/or a specific MRI scan of the soft tissue in the neck area are the best methods for this examination. We also offer an MRI part of the body scan with the emphasis on the arteries of the neck. This is a so-called MRA and is focused on the arteries. A supplementary MRI of the soft tissue of the neck can be included for complaints in the neck area. This scan, however, has limitations and a consultation with an internist may be a better option.

Bladder and prostate (men)

In an MRI scan, small tumours in the bladder and prostate sometimes may remain concealed. In the scope of preventive examination of the prostate a supplementary blood test by means of a PSA level check is recommended (this PSA level check is a standard part of the extensive laboratory tests Prescan offers.)

Bladder, ovaries, uterus (women)

In an MRI scan small tumours in the bladder and ovaries sometimes remain concealed. The MRI examination of the female pelvis is not a substitute for the regular preventive gynaecological examinations (cervical smear).

Laboratory results

A scan shows the anatomy of organs and blood vessels, but does not provide any information about the quality of your blood and the functioning of organs such as liver, kidney and thyroid. Furthermore, latent risk factorssuch as a heart infarct or a stroke can be traced from the blood. This is why the laboratory research is an essential complement to the body scan. In addition to blood, urine and faeces are tested. There are various other diagnostics for colorectal cancer and the presence of diabetes.

Dermatology examination

With the standard body scan, one looks inside the body, the skin is not diagnosed. Do you have moles? Fair skin? Have you been exposed to UV radiation from the sun or a tanning bed? Or do you have little spots on your skin that you do not trust? Then we advise a skin scan. With this scan, a dermatologist inspects and evaluates the noticeable places.

Lymph nodes

Enlarged lymph nodes are in the abdominal cavity and may be seen clearly in the lungs. The nature of an enlargement, however, is less well defined and puncture/biopsy may be needed to get clarity. This also applies to diagnostics of lymph node cancer, Hodgkin's disease and Non-Hodgkin's. Lymph node enlargements are often not specific to lymph node cancer. Also the laboratory test results (blood) of these diseases do not always indicate abnormalities. We therefore always recommend that if the lymph nodes are enlarged and there are persistent complaints, to contact your G.P. and if necessary ask for a biopsy of the lymph nodes.

Certainty and results

In some cases the results may not give a definite diagnosis. In cases like this, a follow-up examination, such as a check-up scan after a few months, can be necessary. Also, despite very thorough investigation, doctors cannot give a 100% guarantee about your health.

Incidentally, a suspicion of having a condition may turn out to be nothing after having a supplementary examination. Here we speak about false-positives.

The medical report

A final GP consultation about examinations can either take place in the clinic or as a telephone consultation.

The final conversation with the doctor and the report

In a personal conversation with the GP the outcome of the examination will be discussed with you in detail. You will receive the medical reports a week later.

Despite the fact that diseases often develop through the years, a preventive medical examination is always a snapshot and just shows the state of health at the time of examination. That is why it is advisable to regularly undergo a preventive examination and, be aware of alert signals from your body.

Repeat

Depending on personal risk factors we recommend a total body examination every 1-3 years.

The examination programme for a repeat client may differ in some parts from previous times. This may be due to current medical knowledge, developments and/or personal health circumstances.

Because we do not have insight in your medical record it is important to indicate whether there were significant findings in the intake during your last examination(s). We ask you to always take your last report and CD-ROM images of the previous examination, as the doctor might want to review them.

Liability

Prescan is duty-bound to select hospitals, clinics and doctors that they mediate for concerning quality and the required registrations. The responsibility and liability for the assessment, implementation and evaluation of the medical examinations lies with the hospitals, clinics and doctors with which Prescan has an agreement. The clinics and doctors are insured against possible "medical malpractice". Prescan is not liable for the actions of the medical staff of the clinic/hospital where the investigations take place, or from which damage can arise. Should a dispute arise Prescan may or may not mediate on behalf of the client.