The psychosocial impact of mass screening for cardiovascular risk factors

In Leek, a small town in the north of the Netherlands, 428 men aged between 30-33 years were invited to take part in a screening test for cardiovascular risk factors. Questionnaires were sent to the 267 men who had participated in the screening test as well as to the 161 non-participants, in order to gain an insight into the participatory behaviour and the experience of those involved. The non-participants gave a diversity of motives for not taking part but did not admit to anxiety about finding abnormal results. More than half of the participants who replied (51%, n = 107) were found to have an 'abnormality'--that is they scored on one or more of cigarette smoking, overweight, hypertension, hyperlipoproteinaemia, albuminuna or glucosuria. The supplementary information provided on nutrition and smoking caused a large proportion of them to claim they had changed to a more healthy life-style after the screening test. Those who were under the impression that they had led healthy lives but were still found to have an 'abnormality' were often very astonished and sometimes worried about the result. The men without 'abnormalities' did not lead significantly healthier lives than the rest in terms of exercise, smoking, diet and so on; for them the result might have a 'certificate of health' effect justifying their not always healthy behaviour.