What items should be checked in a routine physical examination

There is no nationally unified fixed list of items for routine physical examination. The core logic is to cover basic disease screening + personal high-risk factor screening. The basic package in the range of 300-800 yuan is completely sufficient for healthy ordinary candidates. There is no need to blindly pursue expensive "all-item packages".

Last week, I helped the company’s new post-95 operator to adjust the physical examination package. He stayed up late all the time to eat takeout. Last year’s physical examination showed that he had high uric acid and a family history of fatty liver. The original package issued by the company only included three items of basic liver function. I helped him replace the useless “12 items of tumor markers” with alpha-fetoprotein + liver transient elastography, and added a blood uric acid review. The overall cost was nearly 500 yuan less, and it was much more targeted.

Speaking of which, some people must want to ask, if I don’t feel any discomfort, have no family history, or have bad living habits, will I miss the test if I only select the most basic items? In fact, it’s really not the case. Those seemingly inconspicuous basic items hide a lot of early signals from the body. For example, a blood routine is not just about checking for anemia. Abnormal fluctuations in white blood cells and platelets can indicate infection and coagulation problems. Micro-urinary protein in the urine routine is an important signal of early kidney disease. Many people are diagnosed by physical examinations and usually don’t feel any pain at all.

Whether Helicobacter pylori, which is a hotly debated issue on the Internet, should be tested every year, is actually not unanimous in the industry. Some gastroenterologists believe that sharing meals is common in our country. As long as adults who often eat out, it is necessary to have a carbon 13 breath test every year. Early eradication can significantly reduce the risk of gastric cancer. Some experts believe that if you have no stomach discomfort and no family history of gastric cancer, you can check once every two or three years to avoid over-medication due to asymptomatic positive results, which will disrupt the gastrointestinal flora.

When you go to the physical examination center next time to choose a package, don’t listen to the salesman and add a bunch of useless high-end items. Last time I met a young girl who had just started working. She saved two months’ salary and chose a “comprehensive cancer prevention package” of more than 2,000. More than 20 types of tumor markers were checked, and one of the indicators was slightly higher than a few tenths. She was so scared that she had insomnia for almost half a month. There was nothing wrong with the re-examination. She just spent money to find fault.

Oh, by the way, don’t think that basic medical and surgical examinations are just a formality. Experienced doctors are very sensitive to touching the thyroid gland and superficial lymph nodes. When the old doctor in our community examined Aunt Zhang downstairs last year, he felt a small hard nodule on her thyroid gland. She did not report the ultrasound for the previous two years. She went to a tertiary hospital for a reexamination and it turned out to be Category 4a. She recovered very well after having it removed as soon as possible.

There are also gynecological examinations that female friends are concerned about. It is now generally accepted that TCT + HPV combined screening should be done every year after sexual intercourse. However, there are also clinical studies showing that if HPV and TCT are negative twice in a row, the screening interval can be extended to 3 years. It does not need to be done every year, and unnecessary invasive examinations such as colposcopy biopsies can be avoided.

In fact, a routine physical examination is simply an annual "minor overhaul" for the body. You don't need to pursue all the items. The most useful one is the one that suits you. If you are really unsure, ask a friend who works in a hospital or physical examination center in advance. It is much more reliable than choosing blindly on your own.