Kim Kardashian recently posted a Instagram message touting the use of full body scanners as a way to save lives.
Companies, like Prénuvo as Kardashian mentioned in her article, are promoting full-body scans in an effort to advance preventative medicine and healthcare. These scans are capable of imaging the internal structures of the entire body, detecting a wide range of health problems, including cancer, inflammatory diseases and cardiovascular disease.
Potential benefits of these scans include early detection of illnesses that, in some cases, could be life-threatening, giving individuals the opportunity to treat them and potentially save their lives. They also offer a comprehensive body assessment that can be beneficial for those at risk for a multitude of diseases if patients have strong risk factors for various diseases. Additionally, for asymptomatic patients who are otherwise healthy, these scans can provide assurance that they are not suffering from serious medical problems.
So should these scans be recommended to the general public?
There are many reasons why such testing has not been recommended to the public by the U.S. Preventive Services Task Force. Whole body scans can give false positive results, meaning that a serious abnormality is detected in the body when in reality one does not exist.
A 2019 article published in the Journal of Magnetic Resonance Imaging, who conducted a meta-analysis of studies on preventive whole-body MRIs, found an average false-positive rate of 16%. This means that almost one in five abnormal results detected in whole-body scans were benign and not cause for concern.
False positive results can lead to unnecessary follow-up testing and even invasive procedures in some cases. As an example, consider a patient who undergoes a full body scan which then shows a kidney injury that cannot be entirely classified as benign (harmless). The patient will then need to undergo another examination, possibly an ultrasound, to assess whether the lesion is benign or malignant (harmful). If the ultrasound proves inconclusive, the patient will likely need to undergo a minimally invasive image-guided biopsy of the lesion to provide tissue for the pathologist to make a definitive diagnosis.
Although minimally invasive biopsies are generally safe, they pose some risks to patients, including the risk of bleeding, infection, and injury to nearby structures in the body. If the final biopsy result turns out to be benign and harmless, the result will be a false positive. This false positive would have led to an unnecessary ultrasound and biopsy which could pose real and serious risks to the patient. It also does not take into account the cost of unnecessary tests and procedures, as well as the anxiety that such interventions could create not only for the patient but also for their loved ones.
Whole-body scans can also lead to overdiagnosis, that is, the detection of abnormalities that would never cause symptoms but are nevertheless often treated, which can also lead to risks for patients due to the effects secondary to various treatments.
Finally, full body scans are not affordable for all patients, and most of these tests cost between several hundred dollars and even several thousand dollars. Most insurance companies do not cover the cost of these tests.
Even if these tests were affordable and covered by major insurance companies, their recommendation would not be justifiable from a public health perspective. Public health recommendations and guidelines often depend on risk/benefit profiles as well as clear evidence that a test or intervention will save lives.
There is currently no evidence to suggest that full body scanners save lives. A press release published by the American College of Radiology on this specific topic it says: “To date, there is no documented evidence that total body screening is cost-effective or effective in prolonging life. »
The lack of evidence, coupled with a relatively high false positive rate, which would result in hundreds of thousands of unnecessary tests and procedures if recommended to the general public, makes full body scanners a hard sell.
