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March 1974

Patient Benefit in DiscoveringOccult Hyperparathyroidism

Author Affiliations

Columbia, Mo

From the Department of Pathology, University of Missouri Medical Center, Columbia. Dr. Van Peenen is now at The University of Texas, Medical School at Houston, Texas Medical Center, Houston.

Arch Intern Med. 1974;133(3):430-431. doi:10.1001/archinte.1974.00320150104012

In evaluating occult hyperparathyroidism as a model of the efficacy of "multiple screening," 4,727 adult hospital inpatients were screened for hypercalcemia. Screening discovered only four of six hyperparathyroid patients in the sample, since two of them were normocalcemic. Of the six, only three were good operative risks or would submit to operation. Postoperatively, there was no change in preexisting hypertension in all patients or in nephrocalcinosis in the one person who had it. Since all cases expected to be found in a population of this size were diagnosed without benefit of screening, since therapy was not always undertaken, and since it produced no obvious improvement in health, there seems to be little costbenefit in conducting mass-screening campaigns for the detection of this disease.