Usefulness of Routine Serologic Tests for Syphilis

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ROUTINE serologic tests for the detection of syphilis recently have received criticism relative to their usefulness and cost. The most severe criticism has been leveled against the obligatory premarital blood test that is said to detect relatively few cases of previously undiagnosed syphilis and at a comparatively high cost per test.1 This concept of the worth of these routine serologic procedures is a reversal of the earlier opinion that the procedures are essential to our national welfare. The earlier opinion resulted in the passage of laws in 40 of the 48 states invoking compulsory premarital examination, and also has affected the standards established by accreditation boards for hospitals.2 On the other hand, routine serologic tests for syphilis continue to have staunch supporters, especially among public health workers.3–5 Collen and Linden6 reported favorably on the usefulness of serologic screening in prepaid group-practice plans.

Magnuson, Donohue, Stuart, and Gleeson7 of the Public Health Service recently discussed the advantages of premarital serologic tests for syphilis, which in most states are part of a physical examination. Among the advantages listed are: detection of syphilis; prevention of transmission of syphilis between marital partners; provision of the physician with an opportunity to give health education, sex education, and marriage counseling; detection of other diseases; and provision of an index of the prevalence of syphilis. These authors stated that reactivity rates in premarital blood testing had not declined in the years 1951–1954, the only period for which data were available, and that conservative estimates indicated . . .



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