I’m happy to back Movember, but drop the call for annual health checks
The men with moustaches mean well, says Dr Peter Deveson, but where’s the evidence?
The men with moustaches mean well, says Dr Peter Deveson, but where's the evidence?
Last month, I grew a moustache for charity. For those not familiar with Movember, the rules are simple – starting from a clean shave on 1 November, participants have 30 days to grow a moustache and to persuade people to pay them for doing so. The money raised goes towards charities funding prostate and testicular cancer research and awareness.
Apparently, 240,000 British men have signed up this year, and it's easy to see why. Moustaches aren't currently fashionable and look horrendous in the growing phase, but they're fun to grow.
Movember is mainly about raising money for research, but some of their health advice is suspect. On my ‘Mospace' fundraising webpage there's a tickbox marked ‘Let us know when you've had your annual health check', and this is a central part of the Movember message. ‘Find a doctor and make a yearly appointment each Movember for a general health check. Getting annual check-ups, preventative screening tests and immunisations are among the most important things you can do to stay healthy,' the website says.
I have several problems with this. Firstly, we don't have evidence-based ‘preventative screening tests' for male cancers in asymptomatic patients. Secondly, while annual physicals are routine in some countries and tend to be popular with the public, there's no evidence they improve outcomes in healthy young people.
Thirdly, there's the issue of cost. Movember says 57% of UK participants arrange a check-up on their advice. If this trend continues in 2011, 136,800 asymptomatic men will visit their GP for an evidence-free ‘check-up', costing the NHS an estimated £4,924,800. That's before we factor in the expense of investigating and managing the epidemic of incidentalitis this worried-well-athon will inevitably precipitate.
Awareness campaigns make us feel good. It's nice to think that wearing a wristband, growing a moustache, or walking around at night in your bra will help to prevent cancer. But while the sponsorship funds raised for research are welcomed, there's little evidence raising awareness in itself does anything to improve disease outcomes.
I expect this month I'll see an increased number of young men concerned they might have felt a lump in what is essentially a bag full of lumps – but I don't reckon we'll detect any more cancers than usual.
I don't want to be the Movember Grinch. I'm proud of the millions we're raising towards cancer research, and I applaud the charity's intention to encourage symptomatic men to connect quickly with health services. But check-ups aren't the answer. We shouldn't be basing major medical behavioural changes simply on what feels good.
Dr Peter Deveson is a GP in Epsom, Surrey
To help him raise money for Movember, go here.