5 Things About Wellness and Screening

This Thanksgiving, as families gather around the table, health and wellness should be a topic of discussion. This is the ideal time to discuss family genetics and get a better understanding of what health risks you might face. Topics of sickness and advanced care planning may not seem like ideal family dinner conversation, but they will better prepare you and your loved ones for any surprises down the road.

Here are 5 things to know about health, wellness, and screening.

1. Family history impacts screening recommendations.

In recent years, genetic testing for screening has seen tremendous development and gained public attention, explains David C. Collymore, MD, MBA. Being aware of a strong family presence of breast and ovarian cancer can help people discover the risk sooner rather than later.

While the American Cancer Society (ACS) is now recommending delaying mammograms 5 years and screening less frequently for breast cancer, this new guidance update does not apply to people with a family history. In fact, women with an increased risk of breast cancer—which includes women with a known BRCA1 or BRCA2 gene mutation or a first-degree relative with these gene mutations or who have had radiation therapy to the chest between the ages of 10 and 30 years—should get an MRI and a mammogram every year starting at age 30 years. ACS places a strong emphasis on the need for discussions of personal and family medical history, which can be used to determine risk profile.

Similarly, while research suggests delaying prostate cancer screening in men until after age 55 years, men with a family history of prostate cancer should discuss their risk with their care provider as early as age 45 years.

2. Screening indeterminately for diseases is not helpful.

The reason why screening recommendations differentiate individuals with average risk and with high risk is because screening asymptomatic patients does not necessarily save lives and rarely decreases mortality.

A study from Harvard and Dartmouth found that widespread use of screening mammography increases the chances of detecting small cancers that may not be clinically relevant. In fact, increased screening results in overdiagnosis without impacting mortality from breast cancers. Overscreening can unnecessarily expose patients to toxic drugs and increases healthcare costs.

JAMA published a study that found patients can have unrealistic expectations of the benefits and harms of common medical treatments, tests and screens, and often overestimate the benefit of an intervention while underestimating the harms.

3. Employers are really investing in wellness programs.

As the focus in healthcare begins to shift to prevention, more and more employers are offering wellness programs to improve employee health. Fidelity Investments and the National Business Group on Health found that employers are spending more on wellness-based incentives compared and 79% of employers are offering health improvement programs.

Employers are even willing to shell out money to increase wellness program participation. RAND researchers found that a majority (75%) of companies offering wellness programs are also offering incentives to increase employee participation and some are implementing penalties or surcharges for not participating in the program.

4. Employees either lack of awareness or don’t take advantage of wellness programs.

Despite these efforts, uptake of wellness programs seems to be lacking so far. While access to wellness programs is on the rise, employees may not be aware of them. A survey found that when 70% of employers said they had a workplace wellness program, only 34% of employees said there was such a program at work. More than that, there is some employee resistance to using these programs due to privacy concerns and doubt that the programs would actually be helpful.

Even when wellness programs use apps, employees still aren’t engaged. The majority cited lack of willpower and distractions for the reason why they haven’t been able to alter their lifestyle despite wellness programs and apps.

5. It is not clear whether wellness programs are really helping.

At the end of the day, it’s still not even clear if these wellness programs actually help. Corporate weight control programs don’t report savings or sustained weight loss and may actually harm morale. A recent study of employers requiring their employees to meet health indicator goals found a coverage gap for people affected by obesity because they do not have access to effective treatments for this chronic disease.

Austin Frakt, PhD, a health economist and researcher, explained that corporate wellness programs are not as effective as they claim they will be. He said that because these programs aren’t targeted properly to where healthcare costs are and who can benefit the most, these programs rarely improve health and lower costs. However, programs focusing on disease management and preventive care usually have better outcomes.