Differences in mortality rates between frequent and occasional participants of periodic health check-ups: An observational study and propensity analysis

PurposeLittle is known about differences in mortality among frequent and occasional participants of health check-ups. We aimed to compare mortality of frequent and occasional participants of the annual health examination in Taiwan.Subjects and methodsWe conducted a cohort study from 2001 until 2007. There were 25,166 participants aged 65 and over in the health check-ups in 2001. Of them, 19,768 participated in the subsequent check-ups (frequent participants), but 5398 participated only once (occasional participants). The outcome measures were all-cause, cancer and cardiovascular mortalities.ResultsCompared to frequent participants, multivariate-adjusted hazard ratio (MHR) for seven-year mortality was 3.28 [95% CI: 2.98–3.62] for occasional participants. In the propensity-score-matched subsample, MHR was 3.18 [95% CI: 2.78–3.65] for occasional participants. Stratified by their participation in increasing order of frequency, all-cause mortality rates per 1000 person-year were 48.89 [95% CI: 46.40–51.37], 30.24 [95% CI: 27.98–32.50], 23.36 [95% CI: 21.27–25.46], 14.88 [95% CI: 13.18–16.58], 8.58 [95% CI: 7.26–9.89], 3.23 [95% CI: 2.46–4.00], and 0.47 [95% CI: 0.19–0.75], respectively.DiscussionThe most likely cause of mortality reduction might be the beneficial effect of subsequent referrals after health check-ups. More frequent participation ensures necessary referrals and treatment were not missed. Screening for multiple diseases detects early cases of various diseases simultaneously. Periodic health examinations also lessen patient worry and improve delivery of preventive services.ConclusionOccasional participants had higher mortalities as compared to frequent participants. This trend persisted after propensity matching. There was an inverse relationship between health examination participation and all-cause, cancer and cardiovascular mortalities.