Participation in a Multiple Screening Clinic with Five-Year Followup

CREENING TESTS are procedures that sort out persons who may have abnormalities from those who probably have none (1). Multiple screening is the simultaneous use of two or more screening tests. Its major aim is the early detection and treatment of disease. However, multiple screening may have no measurable effect on the screened population if most participants are free from undetected illness or are disinterested in seeking care for newly discovered disease, or if the disease found is one for which treatment is not beneficial. It is important to the success of screening, therefore, to know as much as possible about those who participate and those who declinie to participate, and, if necessary, to develop better methods for attracting groups who will benefit most from screening. Participation in some types of health programs has already been well studied. However, there is relason to believe that patterns of participation will not be the same for all preventive programs. Programs aimed at different diseases or involving different procedures may appeal to one population more than to another. For example, tuberculosis and poliomyelitis may be perceived in different ways by whites and nonwhites. Participation in programs aimed at eradicating each disease has differed with race, nonwhites being the more attracted to the chest X-ray programs. Participants in multiple screening, aimed alt a variety of diseases, may differ from those attracted by single screening programs. Finally, even though it detects similar groups of diseases, multiple screening may attract different participants from those who are attracted by physical examination programs. Multiple screening is faster than physical examination and involves no undressing and no personal contact with a physician. The purpose of this study is to contrast the characteristics of participants and nonparticipants in a multiple screening clinic, to describe their response to a questionnaire mailed in 1960, 5 years after screening was completed, and to compare change of residence figures. The study will also present mortality trends, causes of death, and morbidity figures for each group for the 5 years following screening.