Relationship between the achievement of successive periodic health examinations and the risk of dying. Appraisal of a prevention scheme
- Correspondence to Dr Joseph Henny, Centre de médecine préventive, 2, avenue du Doyen Parisot, 54501 Vandoeuvre-lès-Nancy, France;
Contributors RG initiated the project and then he designed and monitored the statistical study. AP wrote the statistical analysis plan, cleaned and analysed the data. JH drafted the manuscript. RG, TG and MH revised the draft paper. All authors have seen and approved the final version of the manuscript.
- Accepted 30 March 2012
- Published Online First 5 May 2012
Background In the field of Periodic Health Examination (PHE), few studies brought information on their efficiency, both on morbidity and mortality.
Objective The association between the reduction of mortality and a regular participation in PHE has been estimated.
Methods This study concerned 50 116 persons 40–59 years old, of European origin, examined at the Centre of Preventive Medicine, Nancy, France, between 1 January 1980 and 31 December 1985 with a maximum duration of follow-up reaching 25 years. The risk of dying according to the number of examination was compared (Cox regression Model). The reduction in mortality (all causes as well as cancer and cardiovascular diseases) was significant for persons whose practice of the PHE continued for at least 10 years or more. The second approach used a propensity score. After stratification on the propensity score, the relative mortality risk of those who returned at least once (compared with never) for a new check-up was 0.75 (95% CI 0.69 to 0.82) in men and 0.89 (95% CI 0.78 to 1.02) in women.
Conclusion The survival analysis evidenced a significant reduction of all-cause mortality, as well as of cancer and cardiovascular-related mortality, in men and women having benefited from several PHEs. On the other hand, the Cox model by class of propensity score allowed to show a reduction in mortality only in men who returned at least once, in particular that of a higher health interest among the regular beneficiaries of PHE.
- preventive medicine
- empowerment programmes
- health impact assessment
- longitudinal studies
- health behaviour
- social inequalities
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.