Quantifying the benefits and harms of various preventive health activities

Abstract

It is helpful for general practitioners (GPs) and their patients to understand the amount of health benefit expected from different preventive activities to enable a thoughtful choice of which to adopt first. The aim of this article is to illustrate how it might be possible to quantify the mortality benefit for cancer screening, quitting smoking, losing weight and treating lipids, which are preventive activities from The Royal Australian College of General Practitioners’ (RACGP’s) Guidelines for preventive activities in general practice (Red Book). A sample of common preventive activities was taken, with an outcome for each selected for fair comparison, and benefits and harms were estimated. For a man aged 50 years, the benefit in terms of reduced risk of dying is greatest for quitting smoking (at 24 fewer deaths/1000/decade), which is approximately 10 times the benefit of lowering lipids in a man with metabolic syndrome and about 50 times greater than from participating in regular colorectal cancer screening. Benefits for women are generally lower, as their baseline risk is lower. It is feasible to quantify the benefits of some preventive activities, although estimating them is not straightforward and requires several assumptions. Nevertheless, extending estimates such as these to the items in the RACGP’s Red Book would assist GPs and their patients’ preventive activity prioritisation.