"Don't do prostate ultrasound." Doctors know all about 'wild money' health checkups.

YTN Radio (FM 94.5) [YTN News FM Wise Radio Life]
□ Broadcast Date: November 13, 2024 (Wednesday)
□ Host: announcer Lee Hyun-woong
□ Cast: Woo Chang-yoon, internal medicine specialist at Asan Medical Center

* The text below may differ from the actual broadcast content, so please check the broadcast for more accurate information.

◆ announcer Lee Hyun-woong (hereinafter Lee Hyun-woong): I forgot about the beginning of the year and the year, but when the end of the year approaches, I suddenly think of something. Health Check-up The season of health check-up peak season has just come this year. There are basic health checkups conducted by the country, but there are also items that cost money for additional tests. If you look at the paid health check-up items, there are a lot of these. There are times when I'm worried because I don't know what to do. So, let's see if there are all kinds of health checkups that we can find out during the peak season today, essential health checkups, and items that can make you lose money. I'm also getting text messages about my questions. Professor Woo Chang-yoon, an internal medicine specialist at YouTube Doctor Friends, is with us. I'm on the phone. How are you?

◇Woo Chang-yoon, internal medicine specialist at Asan Medical Center in Seoul (hereinafter, Woo Chang-yoon): Yes, hello. I'm Woo Chang-yoon.

◆ Lee Hyun-woong: You're with us through the phone again today. It can be said that we are a wise radio doctor, but if you are a citizen who pays health insurance premiums, you can receive regular medical checkups in the country. First of all, why do you have to get a medical checkup?

◇Woo Chang-yoon: If we discover it in the early stages of the disease, there are many diseases that we can cure at a much lower cost and without any aftereffects. Since that period is limited to everyone, I find the disease during that time, pay more attention to my health, and have a checkup in the hope of a cure.

◆ Lee Hyun-woong: I think there are many cases of receiving it every year or two, is this enough?

◇Woo Chang-yoon: So whenever I have a checkup, I always tell them when the next checkup will be. So it's actually okay, but doing checkups too often is not just blood tests, but endoscopy and other things can be cumbersome and the procedure itself can be dangerous. The period itself also varies slightly depending on the condition of my body after the first checkup for each individual.

◆ Lee Hyun-woong: Basically, it's a year or two, but it may vary depending on the test results, so please refer to the information. Gastric cancer, breast cancer, colorectal cancer, cervical cancer, and liver cancer will also need to be examined for the five major cancers that many people take. In addition, lung cancer has been added from 2019?

◇Woo Chang-yoon: That's right. There are men and women aged 54 to 74 who are at high risk for lung cancer. These people now have a smoking history of 30 pack years, and if they're like this, they take a low-dose chest CT every two years. But the reason why this is possible is that in the past, taking a chest CT scan had 70 times and 80 times more radiation exposure than just taking a chest X-ray, but now that low-dose chest CT has radiation exposure taken 10 to 15 times. So this became possible, and now high-risk lung cancer patients can now be examined.

◆ Lee Hyun-woong: Then can I get it through a cancer screening supported by the state?

◇Woo Chang-yoon: That's right. But you have to be old and have a smoking history in order to receive what the state does.

◆ Lee Hyun-woong: I see. I see. I've already told you about the cancer check-up here, but I think there are a lot of people who are about to have a medical check-up. And I think there are a lot of people who have questions. Professor Woo Chang-yoon of Seoul Asan Hospital, who is with us now, is an internal medicine specialist at Seoul Asan Hospital. Questions related to internal medicine diseases, questions related to health checkups, send them to #0945 and we will try to solve them during the broadcast. You also mentioned endoscopy, but at what age is it good to get an endoscope?

◇Woo Chang-yoon: According to the national examination criteria, it is said that stomach cancer starts from 40 years old and colon cancer starts from 50 years old. Young colorectal cancer is increasing so rapidly these days. Korea's young colorectal cancer is the number one in 49 countries. It's increasing a lot. So even young people have symptoms. If there is blood, bowel movements are not the same as before, or if there is a residual stool, we always tell them to check-up. Young people have a bad prognosis for colorectal cancer, which is about six months later than older people to be diagnosed after symptoms develop. So, if you have uncomfortable symptoms or have a history of colon cancer in your family because of the delayed diagnosis and poor prognosis, you usually tell them to get a checkup in their 40s or from then. Gastric cancer starts from the age of 40, but in the case of women, we always ask them to get it after getting married and before getting ready for pregnancy. This makes me feel nauseous when I get pregnant. But at that time, you always think that the symptoms of nausea are just because of this child. The symptoms of gastric cancer can also be heartburn and nausea, but at that time, it is difficult to treat even if it is found without being tested.

◆ Lee Hyun-woong: That's possible.

◇Woo Chang-yoon: So I've experienced those cases a few times, so if you're preparing to get pregnant, I tell you to try it.

◆ Lee Hyun-woong: Some say it's better to get a gastroscopy even in your 20s, right?

◇Woo Chang-yoon: If you have uncomfortable symptoms, young people suffer a lot from gastroesophageal reflux or indigestion. But even if it's not necessarily cancer detection to see if there's really a structural problem. If you have this kind of pain because of some ulcer or other structural abnormality in your stomach, the duration of treatment or the weakness of some treatment may vary. So, even if it's not necessarily due to cancer, it's worth getting it if you've been experiencing symptoms of digestive systems that are uncomfortable for more than three months.

◆ Lee Hyun-woong: I don't think I smoke much these days, I think I've lost a lot of alcohol, and it seems that eating healthy is a trend, but I don't think this stomach cancer or colon cancer comes from that kind of place.

◇Woo Chang-yoon: This is a huge lack of sleep. Lack of sleep and people's physical activity itself has decreased a lot. The amount of physical activity has decreased, and since we don't live together in a family and live alone, we eat a lot of convenient meals, ultra-processed foods, and delivery foods, so we have an overwhelming lack of dietary fiber. According to the survey, about 70 to 80% of them eat insufficient dietary fiber, but their sugar intake has increased. Therefore, the various substances in this processed food are the parts that the intestinal mucosa has to deal with, so the incidence of colorectal cancer is increasing.

◆ Lee Hyun-woong: Colonoscopy. Those of you who are a little scared of endoscopy, can I do it in a different way?

◇Woo Chang-yoon: There is a fecal occult blood test. What kind of test this is, blood comes out now. When colon cancer grows, cancer cells don't grow beautifully, but they break out and bleed in places. So, if there is blood that is invisible to the naked eye in the stool, it means that the cancer is growing, so there is a fractional occult blood test. But we don't recommend it. Personally. Theoretically, colon cancer starts with adenoma growing very beautifully, and then it grows like a lump, and when it grows, it becomes colon cancer, and then blood comes out in the process, but naturally, adenoma does not produce blood. So, in early adenoma, even if you test this, it doesn't come out to less than 10%. It doesn't come out within 10%, so you miss it a lot. Even in the case of fairly advanced colorectal cancer, about 30% or 40% will be missed. And if there's something wrong, you have to do colonoscopy again anyway. And if you're young, you're likely to have this kind of polyp. But in 5, 10 years, it becomes colon cancer, and it's to find and remove it, so we recommend colonoscopy a lot in Korea, especially because colonoscopy is so inexpensive and accessible. There are many areas where colonoscopy is difficult for this test. There's also a country. Of course, it's used meaningfully enough in these places.

◆ Lee Hyun-woong: Speaking of a occult blood test in feces, I'm curious about the blood test or urine test when you go for a basic medical check-up. I'm also curious about what I can know from this and whether it's a little late if I know it the day before yesterday.

◇Woo Chang-yoon: The blood test is. It tells you so much. It tells you the overall health status, and first of all, you can see the general health status such as blood sugar, cholesterol, liver function, heart function, anemia, inflammation, and electrolyte levels. These are not like cancer. It's something that you need to check your condition by looking at your blood sugar and cholesterol function a little more often every year or quarter.

◆ Lee Hyun-woong: What about the urine test?

◇Woo Chang-yoon: And a urine test. First of all, there are proteinuria, whether glucose comes out in the urine, and infections with urinary tract. I look at the overall condition to see if there is something like this.

◆ Lee Hyun-woong: I think it's a little simple, and I can neglect it because I do it every year, but this is also very important, so I think you need to look closely and listen to the comments again.

◇Woo Chang-yoon: Especially in the case of urine tests, if you have proteinuria or hematuria, you can think of it as a really screening test because there is nothing wrong with the kidney.

◆ Lee Hyun-woong: Okay. There are many questions about various ultrasound tests, but there are also various ultrasound tests such as thyroid abdominal ultrasound in addition to the uterus and breast. Do you really need an ultrasound?

◇Woo Chang-yoon: There is an ultrasound test that I tell you not to do. In fact, it is correct not to do prostate ultrasound. Prostate ultrasound is usually included in the examination. For the purpose, there will always be fewer stories about prostate cancer, but looking at prostate cancer like that is peculiarly a blood test called PSA, so we can be more sensitive to prostate cancer. So, in fact, PSA was high. Then, what purpose is prostate ultrasound? When you do a biopsy, you have to look at ultrasound. In that case, I actually do ultrasound or I just have prostate hypertrophy, but I want to measure the size of this. The size of the prostate is actually used, but to see cancer, a blood test is suitable for the prostate, so you can actually take it out.

◆ Lee Hyun-woong: I see. What is something like this that really helps? Usually, most of the time, I go to the website of a medical institution for medical check-ups and look around or through counseling materials, but there are cases where it is divided into gold and silver. Each amount is very different and the inspection items are different, so it's not like you can pay a certain amount of money to do this and do everything. There are many cases where it's a choice, so I have a lot of worries. I hope that those who are about to have a health checkup this year get a test. Is there an item that you do?

◇Woo Chang-yoon: Gastrointestinal endoscopy is the most effective in our country. In particular, it is recommended to have a colonoscopy instead of a colonoscopy fecal occult blood test. People look at it at the health checkup and overlook it the most because of the fasting blood sugar test. So, if the fasting blood sugar test doesn't go up to 120 like this, it doesn't say diabetes, but it says it's in the pre-diabetes stage.

◆ Lee Hyun-woong: That's often the case.

◇Woo Chang-yoon: Then I think people are okay. But what's very meaningful is that it's similar to discovering an adenoma. There's no problem if you take it off at this time. This metabolic disease is called the domino. At the front end, each one is erected, so you can stand it even if you fall from here, but when you go back, the dominoes are intricately woven, so we can't stand it up by hand. But this fasting blood sugar disorder is really in the stage of diabetes mellitus, and if you don't manage it here, you have a very high probability of diabetes. So, at this stage, I regularly go to endocrine departments or hospitals like this, and it's a signal that it's the last time you can check your diet and activities and decide your own path of life, but you always go to the hospital after you become diabetic. So I hope you don't ignore this. I want to tell you.

◆ Lee Hyun-woong: The listener. "Every time I go, I'm really at a loss because I don't know what to choose for the additional examination. Please let me know what is good to do among the options other than the essential ones. "I'm a man in my mid-40s," what's good about a man in his mid-40s?

◇Woo Chang-yoon: A man in his mid-40s. If you're obese, you'd better have an abdominal ultrasound. However, there are cases where abdominal CT is included in chest CT as an option these days. Then, you don't need to do CT and ultrasound together. Unless it has a special purpose. That's why it's usually done a lot. If you do chest abdominal CT and gastrointestinal endoscopy, most cancers are filtered out, and then abdominal ultrasound is eliminated. And the only thing that's meaningful with a blood test is PSA, which I mentioned earlier. Alpha phytoprotein, a marker test for liver cancer, is also a high-risk group for liver cancer. This alpha phytoprotein is also meaningful, and there are a lot of cancer marker tests. All of these friends have auxiliary meanings, so you don't have to do it. Because it can go up in other inflammatory or benign diseases, additional tests are performed, and the additional test is an imaging test anyway. So if you're going to do an imaging test, you don't have to do standardized tests. I think you can think of it like that.

◆ Lee Hyun-woong: Okay. A lot of people are talking about CT right now, but there's one thing I didn't say today on the website. It's an MRI. Do I have to get an MRI?

◇Woo Chang-yoon: No. If I took an abdominal CT, I don't need an abdominal MRI. Unless it has a particular purpose. That's why MRIs usually take a lot of pictures of the brain. MRI takes a long time, but it can distinguish between water and oil well, so the general recommendation for taking a picture of the head is whether to look at blood vessels or cancer. But I don't take MRIs to see cancer. In fact, brain cancer has an age group at the beginning of the brain tutor. The incidence rate is really low in the middle age group when you are young or old, so I don't recommend it. If so, the reason for taking an MRI is whether there is a possible brain aneurysm. However, the probability of this is so low that we generally don't recommend it to population groups. Because it's not cost-effective. However, MRI is a very safe test for individuals because there is no radiation exposure. So if you say you're curious or worried at least once in your life, they say it's okay to film the first episode. This is because there is no radiation exposure.

◆ Lee Hyun-woong: Okay. Teacher, we have about a minute left and this is what you've said so far, but it's essential in the last sense of emphasis. Or, please summarize a little bit of what you can do about unnecessary tests and organize it one last time.

◇Woo Chang-yoon: First of all, the things that come out of the national examination. It's just cost-effective tests, so it's a really low-level recommendation to save money, so you have to do it, but older men usually don't do it. So you must do the recommended tests. What is unnecessary is that prostate ultrasound, CT, and ultrasound are repeatedly performed, and among cancer marker tests, only PSA alpha phytoprotein is not used as a cancer screening test.

◆ Lee Hyun-woong: Okay. Do you also have PET-CT?

◇Woo Chang-yoon: PET-CT is about taking pictures of the whole body. If you just test it, it's very sensitive, so it's hard to distinguish between inflammation and cancer. So I'm rather worried about the first cancer screening. Then, the cost of taking a CT scan is much cheaper, almost a fifth or a seventh, so it is much better to take a low-dose chest abdominal CT scan. When PET-CT is used this time, when cancer is diagnosed, it is usually tested a lot to see how far the cancer is. Or in an infectious disease.

◆ Lee Hyun-woong: The listener said, 'PET-CT can detect all early cancers, should we try it? He asked me like this.

◇Woo Chang-yoon: I don't recommend it. It's so sensitive that you're likely to do a lot of unnecessary tests after that.

◆ Lee Hyun-woong: Let's stop listening to it. I was with Woo Chang-yoon, a professor of internal medicine at Asan Medical Center in Seoul. Thank you, teacher.

◇Woo Chang-yoon: Yes, thank you.