In this guide
Many checkup packages, especially abroad, include tests that US guidelines don't recommend for people at average risk, such as tumor-marker blood tests and chest CT scans. Extra tests can trigger false alarms, more scans, more radiation and procedures you didn't need. The best package matches your age and risk, not the longest list.
A real example
A basic checkup at a Shanghai hospital's international department is listed at US$377 (list price US$447). Alongside standard blood tests, ultrasound and an ECG, it includes:
- Two tumor-marker blood tests (CEA and AFP)
- A low-dose chest CT scan
Both look reassuring on a list. Neither is recommended by US guidelines for most people.
What US guidelines say
Lung CT screening. The USPSTF recommends yearly low-dose CT screening for adults aged 50 to 80 with a 20 pack-year smoking history who smoke now or quit within the past 15 years. For people who don't meet those criteria, the recommendation doesn't apply.
Tumor markers. Blood tests such as CEA and AFP aren't recommended to screen people at average risk. The American Society of Clinical Oncology advises against using CEA to screen for colon cancer, and the American Cancer Society says there's no widely recommended liver cancer screening test for people at average risk. These markers are mainly used to monitor people already diagnosed, and AFP, with ultrasound, for some higher-risk groups such as people with cirrhosis.
Whole-body scans. The American College of Radiology has said there's insufficient evidence to recommend total-body screening for people without symptoms, risk factors or a relevant family history.
Why more tests can hurt
Every test has a false-positive rate. Run enough tests on a healthy person and something "abnormal" will turn up. Then:
- A follow-up scan, often with more radiation or contrast dye
- Possibly a biopsy or other procedure, with its own risks
- Weeks of worry, and more bills
- Often, the conclusion that nothing was wrong
The economist's test is simple: a test is worth its price only if the result would change what you do. A test that leads to nothing useful but can trigger a cascade of others has a hidden cost.
How we build packages
- Start from US screening guidelines for your age and sex.
- Add extras only with a clear reason, and label them as optional on every quote.
- Recommend you review the list with your own doctor before you book.
How to read any checkup package
| On the package | Question to ask |
|---|---|
| Tumor markers (CEA, AFP, CA-125, etc.) | Am I in a group these are meant for? |
| Chest CT | Do I meet lung screening criteria? |
| Whole-body MRI or CT | What would happen if it finds something small? |
| Endoscopy | Is this screening or diagnostic for me, and how is sedation handled? |
| "Cancer screening package" | Which cancers, and which tests are guideline-based? |
Questions to ask your doctor
- Which tests on this package are recommended for my age and history?
- Which would you skip, and why?
- If something unexpected shows up, what would the next step be?
Sources
- Bookimed: Shanghai Tongji Hospital basic checkup listing us-uk.bookimed.com
- USPSTF: lung cancer screening uspreventiveservicestaskforce.org
- ASCO: tumor markers in gastrointestinal cancer, 2006 update (PubMed) pubmed.ncbi.nlm.nih.gov
- American Cancer Society: can liver cancer be found early? cancer.org
- ACR statement on screening total-body MRI (2023) acr.org
Please note. General information, not medical advice. Ask your own doctor which tests suit you.
Reviewed at least every three monthsNo paid placementsInformation, not medical adviceOur editorial standards
Joe Yang, PhD, Economics. Joe Yang holds a PhD in economics from the University of Washington. For four years Joe evaluated the costs and savings of US health programs for insurers and employers at a health-analytics company, and before that studied pricing and demand as an economist at Amazon and a data scientist at Oracle. These guides apply the same discipline to a simpler question: what care really costs, and where.