Top ten medical tests you need

Benefits for companies
Diagnostics tests not only save you money, but they can save your company money too. A survey of over 3,000 employers by New York-based Mercer Human Resource Consulting, a subsidiary of insurance broker Marsh & McLennan Companies, found that total health benefit cost per employee has been slowing in recent years, with only a 7.5 percent increase in 2004, compared to a 10.1 percent increase in 2003 and a 14.7 percent increase in 2002. In addition to shifting health benefit costs to employees, more and more companies are curbing health care costs by encouraging their employees to take advantage of preventive medicine. Sometimes it's more efficient to dish out cash to decrease the chances of getting sick than it is to pay for expensive procedures to fix health problems that have become full-blown.

Despite all their benefits, diagnostic tests that enable early detection of diseases are not always perfect. Prostate-specific antigen screening — a simple blood test used to detect prostate tumors — has a high rate of false-negative and false-positive results. The risks as well as the costs of further tests like biopsies present a serious clinical dilemma because not everyone who is in a high-risk category based on PSA screening actually has a high chance of developing a fast-growing, life-threatening tumor.

Dr. Leo Cheng, an assistant professor of radiology and pathology at Harvard Medical School, notes that patients whose tumors appear to be slow-growing might be better off with no treatment. That's because treating prostate cancer can cause complications, such as the inability to have an erection or control urination — not to mention the risks involved with any surgical procedure.

Understand tests' limits
Understanding the limitations of certain diagnostic tests often provides the impetus for researchers to improve existing methods and technologies. Cheng and his colleagues at Massachusetts General Hospital in Boston, Mass., have developed a new way of evaluating prostate cancers that may help physicians differentiate between patients who really need treatment and those who might be better off without it. Their research, which appeared in the April 15 issue of Cancer Research, uses "magnetic resonance spectroscopy" to determine which tumors are likely to spread and which are not, based on chemical profiles of the tissue.

Although there are no plans to try to turn these findings into a new screening test anytime soon, Cheng notes that as technology improves, it is entirely possible that examining the cells of prostate tissue to determine cancer risk could one day become routine.

Most of the tests on our list are covered by PPO insurance plans. If you have an HMO, and you want, say, a stress test, you generally have to get a referral from your designated primary care physician to see a cardiologist, who would then be able to order the test.

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