Health: Routine health checks associated with decreased risk of death

Attending an NHS Health Check appointment — a preventative screening programme offered for free in the UK — is associated with both a decreased risk of dying and a decreased risk of several diseases, including dementia and liver cirrhosis. The results, published in BMC Medicine, suggest that the NHS Health Check and other similar preventative programmes can be effective at reducing a population’s overall risk of long-term disease.

The NHS Health Check is a preventative screening programme designed to identify individuals at risk for heart disease, stroke, diabetes, and kidney disease. Healthy adults aged 40–74 are invited to attend an appointment involving basic physical checks and a health behaviour survey. Attendees are then offered tailored support to delay or prevent the onset of the screened-for conditions. Similar programmes are in place in several other countries, including France and Germany. However, there has so far been little research into the effectiveness of the programme in preventing long-term disease.

Celeste McCracken and colleagues used data from 97,204 UK Biobank participants to investigate associations between attending an NHS Health Check appointment and the risk of death or a future diagnosis of 14 different health conditions. Participants were recruited between 2006 and 2010, with 48,602 members of the cohort attending a Health Check appointment between January 2008 and June 2016. Each participant who attended an appointment was matched with a participant who did not attend one but had similar potentially confounding characteristics such as demographics and health behaviours. Participants’ linked health records were checked for disease diagnosis over a mean follow-up of nine years.

The authors found that those participants who attended an NHS Health Check appointment had significantly lower diagnosis rates for several diseases, including a 19% lower rate of dementia diagnosis, a 23% lower rate of acute kidney injury diagnosis, and a 44% lower rate of liver cirrhosis diagnosis. NHS Health Check recipients also had a 23% lower risk of death from any cause.

The results suggest that preventative screening programmes like the NHS Health Check can be effective at reducing the rates of long-term disease, according to the authors. They note that there may be a self-selection bias in the results, as attendees of screening programmes are typically healthier than those who do not attend. However, the authors argue that the matching process used to choose the control half of the cohort should reduce the effects of this bias.