This report was published by The National Library of Medicine.

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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2643379&dopt=Abstract

The periodic physical examination in asymptomatic adults.

Oboler SK, LaForce FM

Veterans Administration Medical Center, Denver, Colorado.

The components of the periodic physical examination have been evaluated according to contemporary epidemiologic standards. For the asymptomatic, nonpregnant adult of any age, no evidence supports the need for a complete
physical examination as traditionally defined. The efficacy for three screening procedures has been established: Blood pressure should be measured at least every 2 years; women more than 40 years of age should have a breast examination done by a physician annually; and sexually active women should have a pelvic
examination and a Papanicolaou test at least every 3 years after two initial negative tests have been obtained 1 year apart. Because of the prevalence and morbidity of specific diseases, and the sensitivity and specificity of screening
tests, several other maneuvers are recommended for screening asymptomatic adults, although the optimal frequency has not been determined experimentally. Weight should be measured every 4 years. Visual acuity should be tested annually in adults older than 60 years of age. To identify patients at high risk for melanoma, a complete skin examination should be done once. Hearing should be tested by audioscope annually in adults older than 60 years of age. Physicians should encourage patients to have annual dental visits. To identify valvular abnormalities requiring antibiotic prophylaxis, cardiac auscultation should be done at least twice in an adult. Men older than 60 years of age should have a yearly examination of the abdomen for the presence of aortic aneurysm. Although the other components of the complete physical examination may be important in establishing and maintaining the physician-patient relationship, they have not been shown to be effective screening maneuvers for asymptomatic disease.

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