Should You Sign Up For Life Screening?

Health column by Dr. Greg Feinsinger. Champion of Whole Food Plant Based Living and righteous person.

Recently there have been pink inserts in local newspapers advertising health screening by a company called Lifeline Screening, which has been coming to our area for years. People are asking doctors if they should sign up for this testing, which costs $181 and is not covered by insurance or Medicare.

It is always best to prevent disease, and it’s estimated that 80 percent of the chronic diseases that Americans suffer and die from would be prevented if everyone simply ate more vegetables, fruit, whole grains, nuts and seeds; and moved about more. Next best is catching disease early, when it can be treated and often reversed. Given that heart attacks and strokes, caused by atherosclerotic plaque in arteries, are the number one cause of death in the U.S. (at least in non-COVID years)—and given that almost all these deaths are preventable—it’s particularly important to screen for early disease in arteries. Let’s look at the tests offered by Lifeline Screening, none of which involve radiation:

CAROTID ARERTY (PLAQUE) SCREENING:  The carotid arteries bring blood from the heart to the head and brain. They are located just under the skin on each side of the windpipe, so are easily accessible for evaluation by ultrasound. When disease is present in these arteries, it is virtually always present in other arteries as well, including the coronary (heart) arteries. The Lifeline Screening test picks up significant plaque, which if present should be a red flag for primary care physicians to determine and treat causative factors such as obesity, hypertension, high cholesterol, diabetes, inflammation, smoking, sedentary lifestyle, unhealthy diet, and sleep apnea. A more sensitive test, which picks up earlier, more subtle disease, is carotid IMT, available at Compass Peak Imaging.

SCREEN FOR ATRIAL FIBRILLATION:  This arrhythmia is dangerous, because clots can form in the atria (the small, upper chambers in the heart) and go to the brain, resulting in an embolic (caused by a clot originating somewhere else) stroke. Most people with a. fib know they have a heart irregularity, but not all. If the Lifeline Screening test shows a. fib, you should see your physician right away; if it is not present it could be because the arrhythmia occurs off and on.

ABDOMINAL AORTIC ANEURYSM SCREENING:  The left ventricle of the heart pumps blood through the aorta, the largest blood vessel in the body. In some people, a weak spot develops in the abdominal portion of the aorta, resulting in a bulge called an abdominal aortic aneurysm (AAA). Most people with this condition don’t realize they have it until it bursts, at which point it’s too late to do anything about it because of massive acute blood loss—and some 30,000 Americans die every year from a ruptured AAA. If the bulge is caught early through a screening ultrasound, the weak spot can be repaired. Medical guidelines for screening vary, but in their book “Beat The Heart Attack Gene” Bale and Doneen recommend that everyone have a screening ultrasound for AAA at age 50, and at age 40 if they have risk factors such as smoking, hypertension, or a family history of AAA.

PERIPHERAL ARTERIAL DISEASE (PAD) SCREENING:  PAD is atherosclerotic plaque in the arteries of the legs, which can result in leg pain with walking. Surgery to bypass the blockages, and even amputation are sometimes necessary. Furthermore, if disease is found in leg arteries, it is bound to be present in other arteries such as those in the heart and brain.

OSTIOPOROSIS RISK ASSESSMENT:  Thinning of the bones is common as people age--especially women. However, osteoporosis is not normal and it increases the risk of fractures, which can interfere with quality of life and shorten lifespan. The Lifeline Screening test is an ultrasound of the shin bone. Although this test may be useful for screening, the gold standard test is a densitometry, which checks  bone density in the wrist, hip, and lower spine.

To answer the question of whether you should sign up for Lifeline Screening, if you’re younger than 40, any benefit is unlikely. If older than 40, the screening could be helpful, and the price is right compared to doing these tests individually, especially given that it would be unlikely that your insurance would pay.