PREVENTIVE ONCOLOGIC CHECK-UPS IN THE DISTRICT ŠUMPERK, 1975–1986: THE DESCRIPTION OF A DATABASE

From 1975 through 1986, repeated preventive oncologic check-ups were carried out in the District Sumperk. In the course of the check-ups, 49,426 persons were examined. The examinations were aimed at surveillance of initial stadium of cancers as well as at detection of other serious chronic diseases. The results of the check-ups form a large database suitable for a number of epidemiological analyses. In this article, methods of the data collection are described, individual data items are characterized and their summary is presented in tables. Utilization of the database is proposed in specified types of epidemiological studies.


INTRODUCTION
In 1975, verification of the effectiveness of repeated preventive check-ups was commenced under the guidance of the Ministry of Health of the Czech Republic.The District Šumperk was one of the four districts selected for the project.Originally, the check-ups were exclusively aimed at the early surveillance of initial stadium of cancers.At the very beginning, however, surveillance of other serious chronic diseases, especially of diabetes and hypertension, was included.
The early detection of serious diseases as well as increasing of the population health consciousness were the main objectives of that extensive preventive campaign.
In 1986, the check-ups carried out in the District Šumperk were terminated without any further analysis of the health status of the population.Nevertheless, the records collected in the course of the campaign form a large and unique database.Epidemiological studies analysing such large databases can provide valuable information concerning the relationship between various risk factors and cardiovascular and metabolic diseases, respectively 1,6,8,10 .

METHODS OF THE DATA COLLECTION
The check-ups were commenced in 1975 and repeated in 1979 and 1982, respectively.The time schedule was as follows: The examinations were preceded by an information campaign guaranteed by local newspaper, leaflets, and lectures.The check-ups were accomplished by general practitioners, hospital physicians, and specialists.All participating physicians were trained in the uniform methods of the data collection.Certain variation exists, however, in the data level obtained from individual physicians; careful approach to the data level assessment and their further analysis is essential.
Men and women aged 30-64 were examined.They were invited on basis of the lists of electors.
The check-ups consisted of history records, clinical examinations, and laboratory tests.
History records contained family history including smoking habits and personal and occupational history.Clinical examinations consisted of examination of skin, palpable lymphatic nodes, breasts, abdomen, genitals, and rectum in women.In men, skin, palpable lymphatic nodes, mouth cavity, abdomen, rectum, and prostate were examined and their chest X-rays were made.Body height, body weight, pulse rate, systolic and diastolic blood pressure were recorded for both sexes.Laboratory From 1975 through 1986, repeated preventive oncologic check-ups were carried out in the District Šumperk.In the course of the check-ups, 49,426 persons were examined.The examinations were aimed at surveillance of initial stadium of cancers as well as at detection of other serious chronic diseases.The results of the check-ups form a large database suitable for a number of epidemiological analyses.
In this article, methods of the data collection are described, individual data items are characterized and their summary is presented in tables.Utilization of the database is proposed in specified types of epidemiological studies.tests included blood sedimentation, blood group, glycaemia, total cholesterolaemia, uricaemia, and urine examination focused on detection of the presence of glucose, protein, urobilinogen and blood.Nonspecific tests of stomach acidity and occult stool bleeding were included.
The examinations were analysed and oncologic findings and the stage of cancer risk were assessed 3 .All the preventive check-up records were collected and adjusted for computer analysis at the Oncology Department in Šumperk.

CHARACTERISTICS OF THE DATABASE
At present, a computer data base is available, which includes: 49,426 persons with the record of the first check-up 40,394 persons with the record of two check-ups 1,736 persons with the record of three successive check-ups In the course of the first check-ups, 22,857 men and 26,569 women were examined.In general, men and women aged 30 -64 were examined; a small proportion of them were either younger or older.Mean age of the patients was 46 years (min.18 -max.76years, s.d.9.96 ).In Table 1, numbers of examined men and women are summarized according to their marital status.Specified diseases in the patients' family and personal history are presented in Tables 2 and 3, respectively.
Exposure to harmful factors of the working environment was assessed in occupational history.Number of years of exposure to chemicals, ionising radiation, physical factors, and infectious material were assessed (Tab.4).
Results of clinical examination categorized as negative, suspected, or positive oncologic findings are summarized in Table 5.
The results of laboratory tests included values of glycaemia, cholesterolaemia, uricaemia (frequencies of normal and abnormal values are summarized in Tab.6), blood group (Tab.7), blood sedimentation and tests of urine.

POSSIBILITIES OF UTILIZATION OF THE DATABASE
Data collected in the course of carrying out the preventive oncologic check-ups form a large database suitable for analysis in the following types of epidemiological studies: 1. descriptive studies mapping the prevalence of risk factors for chronic diseases -hypertension, BMI, hypercholesterolaemia, smoking etc. -according to sex and age group; 2. descriptive studies focused on the prevalence of cancers and cardiovascular diseases and diabetes mellitus;  After merging the database with the data from the Regional Cancer Registry, analytical case-control and historical cohort studies will be enabled, dealing with the associations between individual risk factors and developing certain cancers, cardiovascular and metabolic diseases (e.g. the associations between obesity and development of kidney cancer, between the borderline values of glycaemia and development of diabetes mellitus etc.) 2,4,5,7,9 .
In still living and willing to participate persons, current check-ups will be carried out, thus enabling the evaluation of the trend of the risk factors.

SUMMARY
From 1975 through 1986, repeated preventive oncologic check-ups were conducted in the District Šumperk, aimed at the early detection of cancers and other serious chronic diseases.The data collected in the course of the examinations form a unique database, containing a large sum of data.After filtration of the data and recoding a part of the diagnoses according to the actual revision of International Classification of Diseases, the database will be prepared for analysis through descriptive, casecontrol and historical cohort studies.The results of the studies will enhance the understanding of the genesis of serious chronic diseases and will be able to contribute to formulating the strategy of national primary preventive programmes.

Table 2 .
Family history

Table 3 .
Personal history

Table 4 .
Occupational history

Table 7 .
Blood groups