Community-Based Multiple Screening Model: Design, Implementation, and Analysis of 42,387 Participants Taiwan Community-Based Integrated Screening Group

Tony Hsiu Hsi Chen*, Yueh Hsia Chiu, Dih Ling Luh, Ming Fang Yen, Hui Min Wu, Li Sheng Chen, Tao Hsin Tung, Chih Chung Huang, Chang Chuan Chan, Ming Neng Shiu, Yen Po Yeh, Horng Huei Liou, Chao Sheng Liao, Hsin Chih Lai, Chun Pin Chiang, Hui Ling Peng, Chuen Den Tseng, Ming Shyen Yen, Wei Chih Hsu, Chih Hung Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

140 Scopus citations


BACKGROUND. Multiple disease screening may have several advantages over single disease screening because of the economics of scale, with the high yield of detecting asymptomatic diseases, the identification of multiple diseases or risk factors simultaneously, the enhancement of the attendance rate, and the efficiency of follow-up. METHODS. An integrated model of community-based multiple screening was designed and conducted between 1999 and 2001 in Keelung, Taiwan. The authors used a Papanicolaou (Pap) smear screening program as a base to integrate other screening regimens encompassing four other neoplastic diseases and three nonneoplastic chronic diseases. Screening methods, the interscreening interval, and the follow-up for each screening regimen were designed based on evidence-based literature and current national screening policy. RESULTS. A total of 42,387 subjects participated in the screening activities. A 25% increase in the attendance rate for Pap smear screening was demonstrated after the introduction of multiple disease screening programs. At the first screen, this program yielded a total of 677 asymptomatic neoplasms (16.0 per 1000), including a large proportion of precancerous lesions and small presymptomatic tumors without lymph node involvement. The association between the occurrence of neoplasm and the presence of comorbid nonneoplastic chronic disease was found to be statistically significant (odds ratio, 1.64; 95% confidence interval, 1.38-1.94 [P < 0.051). The authors also identified 5314 subjects with metabolic syndrome who were at a greater risk for colorectal and oral neoplasias. CONCLUSIONS. The results of the current study demonstrate that an outreach and community-based multiple screening program not only enhances attendance rates but also has a high yield of early cases of various diseases simultaneously, and provides a natural opportunity to elucidate the correlation between neoplastic disease and nonneoplastic chronic disease.

Original languageEnglish
Pages (from-to)1734-1743
Number of pages10
Issue number8
StatePublished - 15 Apr 2004


  • Cancer screening
  • Chronic disease screening
  • Community-based integrated screening
  • Comorbidity
  • Metabolic syndrome
  • Multiple disease screening


Dive into the research topics of 'Community-Based Multiple Screening Model: Design, Implementation, and Analysis of 42,387 Participants Taiwan Community-Based Integrated Screening Group'. Together they form a unique fingerprint.

Cite this