If You Get a 'Predisease'
For otherwise healthy people who have been told they have a pre-disease, medical experts recommend:
Prevention. Everyone--not just those at risk--can do "the stuff your grandmother told you," says Gilbert Welch, author of Should I Be Tested for Cancer? "Eat right, exercise, sleep, don't smoke. It doesn't require a risk analysis."
Screening. If offered a screening test, Welch says, ask why. How confident in the test is the doctor? Is it appropriate for you? What will you do if it's positive?
Diagnosis. What specifically is your diagnosis based on? If it's a single lab test, what other risk factors are involved? For example, says Michael Alderman, president of the International Society of Hypertension: "The sum total of your blood pressure, cholesterol, whether you have diabetes, cigarette smoking, obesity--all of that together combines to create your risk for a heart attack."
Risk analysis. Understand risk. Don't just accept that your risk of getting a disease is twice that of an untreated person. That's "relative risk"; you want to know your "absolute risk" --the bottom-line risk of getting the disease. If a drug cuts the risk of developing a disease from 2 percent to 1 percent, that's less significant than if it cuts the chances from 60 percent to 30 percent.
Evidence. Ask for supporting research for proposed treatments, suggests Maryann Napoli of the Center for Medical Consumers. Has the treatment been shown to work for everyone, or only the most ill? What about for people who are the same age and sex as you? Is there evidence that it actually extends or improves life? What about side effects?
This story appears in the May 2, 2005 print edition of U.S. News & World Report.