The Needle in the Haystack
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| Many screening tests are not covered by Provincial health plans. |
By: John Mozas, President and Chief Operating Officer
The test must be a false reading, the doctor thought. “Bill” is a client in his mid-40s. He looks great. He pays attention to his diet. He’s in excellent shape. According to recently updated clinical guidelines for prostate cancer screening, Bill was too young to have a prostate-specific antigen test, which recommends the procedure only to men aged 50 to 75. But Bill’s Medcan doctor performed the PSA test anyway, and the test levels were so high the doctor thought there must have been a mistake. Bill did another PSA test—and the results were the same. Turns out Bill had prostate cancer. We picked it up early and intervened so now he’s fine. The harsh reality is that he would not have survived if he waited to get a PSA test at the clinically-guided age of 50.
Bill’s was just one of the 66 cancers Medcan picked up in 2011. We also picked up 506 cases of life-threatening cardiovascular disease. Cancer and heart disease are the number one and two top killers of Canadians. Each year, 177,800 cases of cancer get diagnosed in this country, and each year 75,000 people will die of the disease. Approximately 70,000 Canadians per year will die of cardiovascular disease in a given year.
Many of those numbers are preventable. Which is why we exist. Medcan exists for the individuals who value their health enough to do a little more than what the provincially funded healthcare system provides.
Preventive screening was at the centre of an ongoing discussion in the medical community in 2011. Our public system has entered an era of fiscal challenge—one that sees government bureaucrats forced to make tough choices about the kind of medical care they provide to the public. There just isn’t enough money for all of us. So our public system has begun to ration care—by allowing interminable wait times before it’s possible to get in to see a specialist, for example, and by limiting access to such preventive screening measures as PSA testing for men and mammography for women.
In my view, an inherent conflict of interest exists when government task forces decide standards of medical care. Government leans on the side of cost control; it makes trade-offs between money and screening. If only 1% of men between 40 and 50 years old have prostate cancer, it’s just not cost effective to test all men between 40 and 50. The problem is, what if I happen to be in that 1%?
At Medcan we’ve developed evidence-based leading-edge clinical protocols that help find that 1%—the needles in the proverbial haystacks. Each year we get better. Each year we conduct more Comprehensive Health Assessments. Each year, the number of cancers we catch increases. From 35 in 2009, to 59 in 2010, and 66 in 2011 based on 15,000 Health Assessments a year.
We’re well into our third decade of business here at Medcan. The data we’ve collected during our time in business indicates approximately 35% of our clients have conditions that require some sort of lifestyle adjustment. These are issues that we pick up during the medical. And about 5% of our clients unknowingly have a condition that is potentially life threatening if not treated. Previously undiagnosed, typically with no symptoms.
We’re constantly improving our protocols to detect that 5%. For example, we’ve recently become the first clinic in Canada to offer an advanced cholesterol test that better measures the particle size and density of low-LDL “bad” cholesterol. Next up: An ultrasound procedure that analyzes something called intima-medial thickness, or the width of the arterial walls, in a procedure designed to discern early onset of cardiovascular disease.
Recommendations for preventive care issued by governments who care for entire populations are always going to be different from what you hear from those of us at Medcan, who care for health-focused individuals. Next year we hope that none of our clients develops cancer. But if any of them do, you can bet that we’ll catch it and help do something about it.
Interested in scheduling one of Medcan’s Comprehensive Health Assessments? Click here, or call (416) 350-5900.