The term is generally not meant to include visits for the purpose of newborn checks, Pap smears for cervical cancer, or regular visits for people with certain chronic medical disorders (for example, diabetes). It can involve a medical history, a (brief or complete) physical examination and sometimes laboratory tests.
A systematic review of studies until September 2006 concluded that the examination does result in better delivery of some other screening interventions (such as Pap smears, cholesterol screening, and faecal occult blood tests) and reduced patient worry. Evidence supports several of these individual screening interventions. The effects of annual check-ups on overall costs, patient disability and mortality, disease detection, and intermediate end points such a blood pressure or cholesterol, are inconclusive. A recent study found that the examination is associated with increased participation in cancer screening.
The lack of good evidence contrasts with population surveys showing that the general public is fond of these examinations, especially when they are free of charge. Despite guidelines recommending against routine annual examinations, many family physicians still perform them. A fee-for-service healthcare system has been suggested to promote this practice. An alternative would be to tailor the screening interval to the age, sex, medical conditions and risk factors of each patient. This means choosing between a wide variety of tests.
The arguments for and against are similar for many other screening interventions. The possible advantages include detection and subsequent prevention or early treatment for conditions such as high blood pressure, alcohol abuse, smoking, unhealthy diet, obesity and various cancers. Moreover, they could improve the patient-physician relationship and decrease patient anxiety. Disadvantages cited include the time and money that could be saved by a more targeted screening (health economics argument), a possible increased anxiety over health risks (medicalisation), overdiagnosis and harm resulting from unnecessary testing to detect or confirm medical problems.