Hemochromatosis screening in asymptomatic ambulatory men 30 years of age and older.
OBJECTIVE
To perform a cost-benefit analysis of screening for hereditary hemochromatosis.


METHODS
A total of 3,977 consecutive men > or = 30 years of age who presented for routine health checkups at a health maintenance organization medical center were screened for hereditary hemochromatosis by measuring transferrin saturation. Subjects with repeated transferrin saturation > or = 62% and ferritin level > or = 500 ng/mL (> or = 500 micrograms/L) were referred for liver biopsy. Subjects with transferrin saturation < 15% were referred for evaluation. Laboratory testing, screening, and abnormal screening test evaluation procedures were identified by chart review.


RESULTS
Forty patients had transferrin saturation > or = 62%. One hundred seventy-two had transferrin saturation < 15%. Eight patients with hemochromatosis were identified. The 3 patients most seriously affected had hepatic iron concentrations > 250 mumol/g dry weight. Two of them had hepatic fibrosis. Seven cases of hemochromatosis were found among 1,974 white subjects who were screened. Only 1 case was found among the remaining subjects.


CONCLUSIONS
Our observations support routine screening with transferrin saturation for white men > or = 30 years of age.
Baer
D M
DM
Department of Medicine, Kaiser Permanente Medical Center, Oakland, California 94611-5693, USA.
Simons
J L
JL
Staples
R L
RL
Rumore
G J
GJ
Morton
C J
CJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D003362:Cost-Benefit Analysis; D005293:Ferritins / Q000378:metabolism; D006432:Hemochromatosis / Q000191:economics* / Q000208:ethnology / Q000235:genetics / Q000378:metabolism / Q000517:prevention & control*; D006801:Humans; D008099:Liver / Q000378:metabolism; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000379:methods; D008875:Middle Aged; D011795:Surveys and Questionnaires; D014168:Transferrin / Q000378:metabolism
D014168:Transferrin; D005293:Ferritins