title: Relationship between the achievement of successive periodic health examinations and the risk of dying. Appraisal of a prevention scheme.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: UC-Centre de médecine préventive, Vandoeuvre-lès-Nancy, France. joseph.henny@cmp.u-nancy.fr.
authors.forename: Joseph
authors.initials: J
authors.lastname: Henny
authors.forename: Amélie
authors.initials: A
authors.lastname: Paulus
authors.forename: Michel
authors.initials: M
authors.lastname: Helfenstein
authors.forename: Thierry
authors.initials: T
authors.lastname: Godefroy
authors.forename: René
authors.initials: R
authors.lastname: Guéguen
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009026:Mortality; D009369:Neoplasms / Q000401:mortality; D010808:Physical Examination / Q000706:statistics & numerical data*; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D057216:Propensity Score; D016016:Proportional Hazards Models; D012307:Risk Factors; D017678:Sex Distribution; D044465:White People