Dr Pod: Surveys won’t make you live longer… but might help

Published on Monday 24 March 2008 20:06

YOUR risk of cancer, heart disease and even your life expectancy can now be worked out at the touch of a button.

The internet contains a plethora of so called “risk calculators”, some of which will even calculate your predicted date of death.

Many of these are found on US websites. They ask a series of questions about lifestyle, (diet, exercise, alcohol consumption, stress, sleep patterns), existing health, family history of disease, then use a statistical formula to make a calculation. Hit enter and they instantly feed back the good or bad news.

Of course, these website calculators should not be taken too seriously and are crude, but I was encouraged that many do offer sensible personalised advise, based on the answers, to encourage lifestyle change as a means to improve your odds. Personally, I was delighted to find I’m going to live to be 93, but could improve my chances further by regular teeth flossing!

The concept of “risk management” is new for medical staff and patients alike, and the use of information technology and statistics to aid in this process is still novel. Risk calculators, are however increasingly being used by doctors to calculate patients’ risk of developing heart disease and stroke, the UK’s biggest killers. Indeed new “cardiovascular risk clinics” are popping up throughout the UK to identify and offer preventative treatment and lifestyle advice to high-risk individuals.

Age, blood pressure, cholesterol level, smoking status, presence of diabetes, a history of disease in the family, and pre-existing heart disease are the main risk factors used by these calculators. The calculation however remains crude, as there are still many unknown or poorly understood contributing factors. Genetics undoubtedly plays a huge additional role but, until we have the means to screen genes easily and cheaply in the clinic, this can’t be factored in.

The onus in medicine is shifting from disease treatment to prevention. This will not only lead to better health for the population, but makes financial sense. Health economists are starting to appreciate the rationale behind investing “up front” to negate the greater cost of treating the disease later. As a result, health budgets for preventative treatments have risen dramatically.

GPs already spend considerable time preventing disease through immunisation schemes, cancer screening programmes, smoking cessation clinics and so on. The latest screening programme being piloted in England involves ultrasound scanning of the abdomen to detect swelling of the main blood vessel, a condition called abdominal aortic aneurysm. Aneurysms can rupture suddenly with catastrophic consequences, but can be treated surgically if detected early.

Lifestyle management remains the main preventative strategy for the most common UK diseases. Rapidly rising rates of high blood pressure, diabetes and obesity, however, suggest there is little motivation to change habits. The contribution of lifestyle to health has been further highlighted recently by two major studies. A government report on the nation’s diet suggests almost 70,000 deaths per year could be prevented if Britons followed sensible eating guidelines, saving the economy around 10 billion annually. A Cambridge University study of 20,000 people found taking exercise, not drinking too much alcohol, eating enough fruit and vegetables and not smoking can add up to 14 years to your life.

Our ability to screen for and detect high-risk individuals will continue to improve. A huge step toward disease prevention could be achieved however if the nation simply embraced the principles of sensible healthy living.

&#149 Dr Debbie Wake is a specialist registrar and researcher at the Western General Hospital, Edinburgh. To listen to her podcasts, visit www.drpod.co.uk