Can health screening damage your health?

This study set out to determine whether screening can be psychologically harmful to healthy adults. A prospective controlled study was carried out on 215 healthy adults attending a by-invitation coronary heart disease screening clinic in general practice. The general health questionnaire was used as an indicator of recent psychological distress. Patients attending the screening clinic had significantly lower subjective psychological distress than an unscreened group of 225 age-matched controls, indicating that we may well be screening an already psychologically healthy sub-group. The main finding was that patients' own assessment of their psychological distress was significantly increased three months after screening compared with that of controls, who showed a non-significant decrease. It is concluded that there is a real risk of causing distress by screening healthy adults and that this possibility has largely been ignored by previous studies. Possible explanations and implications of these findings are discussed, particularly in the light of increased pressure from many quarters for more screening services to be set up in general practice.