Screening in health fairs. A critical review of benefits, risks, and costs
D. M. Berwick
Health fairs provide multiphasic screening to more than 2 million Americans
each year, and the number is growing rapidly. Nearly 40 different tests are
in use, commonly including the measurement of up to 30 different blood
chemistry levels. This report reviews the activities in a sample of 940
health fair sites and examines the experience regarding six specific
screening procedures (blood pressure, anemia, blood chemistries, glaucoma,
hearing, and fecal occult blood testing). Widespread use of these and other
tests raises complex issues of cost, risk, and benefit. Rates of false
alarm of healthy people and false reassurance of those at risk may be high
for some tests, and the benefits of detecting new disease are easily
overestimated. Detailed data collection and evaluation could help health
fair sponsors to identify more rational screening strategies.
