Smart Investor Malaysia

Preventive Health Screening

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Going for regular medical check-ups goes a long way in maintaining your health. A medical condition or onset of disease can actually be slowed down or even averted if discovered on time, particularly if there are no symptoms.

Smart Investor talks to Dr Hilwani Kaharuddin of Ara Damansara Medical Centre on why timely intervention can make all the difference.

SI: What is the purpose of Health Screening?

Dr Hilwani Kaharuddin (Dr HK): Many diseases are “silent” meaning they have no symptoms or the symptoms are very vague. For example, you may have hypertension (high blood pressure) and not know it unless you specifically

check your blood pressure. Many people associate hypertension with headaches. However, hypertension only causes headaches when the blood pressure is severely high. You may have had hypertension for years without knowing and all the while the constant high pressure is damaging your kidneys, heart, eyes and so on.

Another example is diabetes. People with diabetes will usually feel thirsty all the time and pass urine more frequently than normal. However, these symptoms may come on so gradually that the person does not notice the change.

Many patients have told me, “I drink a lot of water, so of course I go to the toilet often”. It sounds logical, but these are actually symptoms of diabetes. So, unless you test for diabetes, you will not know.

The idea of health screening is to detect problems or diseases early, when treatment is usually easier with a higher success rate as complications of the disease have not yet arisen.

health

SI: What Tests does one need to Do and When?

Dr HK: It is never too early for a health screening. I have diagnosed diabetes, hypertension and cancer in young people. Talk to your health care provider. Based on your lifestyle, family history and symptoms (if any), he/she will advise the necessary screening tests. Of course there is basic general screening, but it is best to get one that is tailored to you.

For example, someone who has a family history of Thalassemia may need to be tested for that. A young 30-year-old female with no health concerns but is sexually active may be advised to have a PAP smear.

SI: In Malaysia, what is the prevalent disease? Is it Diabetes? Or High Blood Pressure? Or something else?

Dr HK: We are seeing an increasing number of non- communicable diseases in Malaysia. This is largely due to our stressful and unhealthy lifestyle. It is difficult to estimate prevalence of a disease because many are not reported. It is estimated that one in three Malaysians above 30 years has hypertension.

For diabetes, the figure is estimated to be one in 6.5. More importantly, according to the Global Burden of Disease Study, the top five diseases leading to disability or death are:

Top 5 Deadly Diseases

  1. Coronary artery disease
  2. Road traffic accident (which is not a disease but included here due to its significant impact)
  3. Cerebrovascular disease (stroke)
  4. Lower respiratory tract infection
  5. Diabetes mellitus

We need to be cognizant of the fact that both coronary artery and cerebrovascular diseases share the same risk factors, that is hypertension, diabetes, dyslipidemia (high cholesterol), cigarette smoking and so on. These risk factors are easily picked up and addressed with health screening.

SI: Can you give an example where early detection has saved someone’s life?

Dr HK: I don’t know about saving lives, but we do frequently pick up things that need further evaluation. I was attending to a young man once who came in with a heart attack. He was unusually tall and had some physical features which suggest a certain genetic disorder.

He had never noticed he was any different from others because he has always looked like this since young. Then his brothers came in and I noticed they ALL had the same features. Therefore, we arranged for screening and all turned out to have this genetic disorder, which although there is no cure, there are things we can do to reduce their risk of complications. 

There are also young people with abdominal pain who eventually turn out to have colon cancer, or an overweight young man who we diagnose with diabetes and so on.

SI: What is Pre-employment Health Screening and why is it important?

Dr HK: Pre-employment health screening is used to evaluate a person’s fitness to perform the duties he/she will be employed to do and that he/she will not put other colleagues at any health risk. 

SI: What will happen if the employee fails the test? Does it mean he cannot be employed?

Dr HK: If a test is abnormal in the first instance, the potential employee may be advised for further tests or treatment. He/she may be asked to repeat the test at another time or after the completion of treatment. If he/she fails the test a second time, the duty of the doctor is to advice on the potential employee’s fitness to practise. It is up to the employer if they want to proceed to employ the candidate or consider a more suitable position.

SI: Are there risks involved in these tests? What are they?

Dr HK: Screening tests are generally low risk tests. They usually involve an interview with your healthcare practitioner, a physical examination, certain blood tests and may or may not include urine test, imaging such as chest X-ray or ultrasound and ECG.

SI: How long will the tests take generally?

Dr HK: A basic screening test usually does not last longer than half a day in centres where they have their own lab and imaging facilities such as ours in Ara Damansara.

SI: Are there certain things that one should not do/consume before a test?

Dr HK: For most health screenings, you are advised to fast for at least eight hours for your blood test and if you will be undergoing an abdominal ultrasound. However, you are advised to continue your usual prescription medications except diabetic medications despite fasting.

Dr Hilwani Kaharuddin is an Emergency Physician and the Head of Emergency Department at Ara Damansara Medical Centre, Ramsay Sime Darby Health Care.

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