Community-based multiple screening model: design, implementation, and analysis of 42,387 participants

Area of Science:

• Public Health
• Preventive Medicine
• Epidemiology

Background:

• Multiple disease screening offers advantages over single screenings, including cost-effectiveness and improved detection rates.
• Integrated screening can simultaneously identify multiple diseases and risk factors, enhancing patient attendance and follow-up efficiency.

Purpose of the Study:

• To evaluate an integrated community-based multiple screening model.
• To assess the impact of multiple disease screening on attendance rates and early disease detection.

Main Methods:

• An integrated community-based multiple screening program was conducted from 1999-2001 in Keelung, Taiwan.
• The program utilized a Papanicolaou (Pap) smear screening as a foundation, incorporating screening for four neoplastic and three non-neoplastic chronic diseases.
• Screening protocols were evidence-based, aligning with national policies.

Main Results:

• 42,387 subjects participated, showing a 25% increase in Pap smear screening attendance.
• The program identified 677 asymptomatic neoplasms (16.0 per 1000), including many precancerous and early-stage tumors.
• A significant association was found between neoplasms and comorbid non-neoplastic chronic diseases (OR, 1.64; P < 0.05).
• Metabolic syndrome was identified in 5314 subjects, correlating with increased risk for colorectal and oral neoplasias.

Conclusions:

• Community-based multiple screening effectively increases attendance rates.
• The program demonstrates a high yield for simultaneously detecting early cases of various diseases.
• This approach facilitates the study of correlations between neoplastic and non-neoplastic chronic diseases.