Dr. Andrew Manganaro - May 20, 2013
A recent story written by Kaiser Health News which appeared in the Washington Post (Hospitals promote screenings that experts say many people do not need, May 14) focused on the community screening industry, including Life Line Screening. While our perspective was somewhat represented in the story and it included quotes from both Life Line Screening and one of our hospital partners, it also included the viewpoints of a number of our critics, and in the process misrepresented key facts about our preventive health screenings.
We hope you will read the following statement to gain a better understanding of the value of Life Line Screening’s services – and recognize that many who are quick to criticize commercial screenings may not be considering all the facts. You can also read what our many satisfied customers have to say on our Testimonials page – real stories from real patients and the value screenings had for them.
Preventing Screenings Misconceptions
As a clinical vascular surgeon for 30 years, I have seen many terrible health outcomes, including strokes and ruptured Abdominal Aortic Aneurysms (AAA), which could have been easily prevented had the patient only known of their presence. So much death and terrible disability could be avoided by identification of previously unknown disease and successful preventive measures.
In order to prevent readers from developing misconceptions about Life Line Screening and the services we provide, I would like to address several of the key points raised by our critics in the recent Kaiser Health News/Washington Post story:
Why screenings are necessary
Critics in the story assert that Life Line Screening conducts unnecessary testing, with a particular negative focus on vascular screening. The reality is that many people are at risk for diseases such as stroke and heart disease but experience no symptoms until it is too late.
Vascular disease currently represents the top cause of preventable death in the United States. U.S. patients suffer over 800,000 strokes per year – 80% without warning, and the risk of stroke doubles every decade after age 55 (1). Carotid artery disease, a leading immediate cause of strokes (2), can be easily discovered by an ultrasound quick scan while asymptomatic, and with effective management, strokes can be prevented.
Some critics in the article contend that the incidence of disease found from screenings is too low to make them worthwhile. According to our database of over 8 million screenings, approximately 8% of our patients are revealed to have a serious to moderate incidence of disease. We think the chance to alert these patients they are at risk and give them the ability to work with their physician to better manage their health and take action when medical intervention or lifestyle changes can still make a difference, is certainly “worthwhile.”
Who we screen
The story implies all screening companies are the same and will screen the general market indiscriminate of whether it makes sense for the consumer. This is not accurate, as there are many companies who screen based upon recognized appropriate risk factors. This is exactly the case for Life Line Screening. 93% of our patients have one or more risk factors (the same criteria used by many respected hospitals) and the average age of our patients is 62. That’s far from the characterization of broadly screening the general market, and in contrast, supports that our screenings offer a valued healthcare service for today’s seniors – many of whom face significant access to care challenges and need options outside the traditional system.
What USPSTF is, and what it isn’t
The author and others in the story rely heavily on the guidelines of the U.S. Preventive Task Force. However, this organization’s chief role is to provide recommendations to federal programs like Medicare on what services should be paid for with tax-payer dollars – not evaluate new healthcare services for consumers. They do not examine community-based screening for the purposes of early identification and treatment with lifestyle coaching and medical management, which is what Life Line Screening does.
The guidelines referenced are also seven years old and are currently undergoing review, which will necessarily include new evidence in the literature not available at the time of their initial recommendation. For example, under the current limited guidelines for abdominal aortic aneurysm (AAA) screenings, 50% of AAAs will be missed (3).
These facts help to explain why their recommendations, particularly around carotid artery screenings have generated widespread controversy and criticism from well respected experts calling for it to be reexamined – at the very least making it clear that relying solely on this recommendation as a rationale for dismissing these screenings is a mistake.
Hopefully this information and data help clarify some of the information presented in this recent story. If you have any further questions about Life Line Screening and the services we provide, feel free to reach out to Joelle Reizes, our Global Communications Director, at JReizes@llsa.com.
Andrew J. Manganaro, MD
Diplomate, American Board of Surgery
Diplomate, American Board of Thoracic Surgery
Member, International Society for Endovascular Surgery
Fellow, American College of Cardiology
Member, Society for Vascular Medicine
Member, Society for Vascular Surgery
Fellow, American College of Surgeons
Member, Society for Vascular Ultrasonography
Fellow, International College of Surgeons
Fellow, International Society for Cardiovascular Surgery
(1) NIDDS: http://www.ninds.nih.gov/disorders/stroke/stroke_needtoknow.htm
(2) The NIH Carotid Revascularization Endarterectomy vs Stenting Trial (CREST) Fact Sheet, found at: http://stroke.nih.gov/programs/crest-fact-sheet.htm
(3) Kent CK, Zwolak RM, Egorova NN, et al. Analysis of risk factors for abdominal aortic aneurysms in a cohort of more than 3 million individuals. J Vasc Surg 2010; 52: 539-48.