If there is stuff in the ducts, the fact that it’s laying there and not being blown into the rooms is proof positive that it is hurting no-one. The 5-6 exceptions you cite in this article I’ll buy, but only with the caveat that at least some of those could have been avoided by proper protection (during remodeling for example) – and if asbestos/lead/whatever winds up in your ducts- the remodeling contractor should be the one paying to remove it.
Duct cleaning has never been shown to actually prevent health problems. Neither do studies conclusively demonstrate that particle (e.g., dust) levels in homes increase because of dirty air ducts. This is because much of the dirt in air ducts adheres to duct surfaces and does not necessarily enter the living space. It is important to keep in mind that dirty air ducts are only one of many possible sources of particles that are present in homes. Pollutants that enter the home both from outdoors and indoor activities such as cooking, cleaning, smoking, or just moving around can cause greater exposure to contaminants than dirty air ducts. Moreover, there is no evidence that a light amount of household dust or other particulate matter in air ducts poses any risk to your health.