Cost-effectiveness and risk associated with radiological chest screening programmes illustrated at the results of mass-screening in Bavaria/Federal Republic of Germany

In 1975 the German Central Committee on combating tuberculosis, in accordance with international recommendations, proposed to continue non-selected mass surveys as long as more than 4 cases of pulmonary tuberculosis are detected in a total of 10,000 persons whose disease has not yet been detected by other means. In December 1977 the same recommendation was repeated. Meantime, however, the incidence and mortality of pulmonary tuberculosis has decreased so much, that the concentration of an increased morbidity rate has already been limited to a few districts of the Federal Republic of Germany. In 1982 new cases of pulmonary tuberculosis decreased from 19 to 70 per 100,000 with a mean value of about 30. The number of deaths because of pulmonary tuberculosis came to approximately 2.0 per 100,000 inhabitants. Besides regional differences there are great ones between the native population and foreigners. The latter group is much more concerned with the total incidence as well as with regard to the age of the people affected. Therefore it will be necessary to think- over the practice of chest radiographic examination - in accordance the the recommendations of the International Radiation Commission discussed in 1977 and 1982 and the recommendations of the World Health Organisation (WHO) published in 1983