Physical examination of well persons. what is "adequate" for detection of unsuspected disease?

In the examination of 500 "well" executives, the number of unknown diseases found averaged 5.4 per person. Almost half of these executives had newly detected disease that was potentially significant to their health. Treatment was necessary in more than 47.7 per cent of them. One out of five of the total significant unknown defects found was either a peptic ulcer or gallstones; one out of five was a rectal adenoma; and one out of five was either hypertension or cardiac disease. One-third of the executives were overweight. Diabetes was found in every 20th person; and malignant disease was detected in one of every 41 people. For an examination to be "adequate" for the detection of unknown disease, the general physical examination must be complete and thorough. A proctoscopic is necessary, and certain basic laboratory screening procedures should be completed in each individual. Complete and routine x-ray studies of the gallbladder and gastrointestinal tract should be done, since they are the most important single diagnostic procedure, in detecting early, major, unsuspected, and often asymptomatic diseases. Routine consultations with specialists are a valuable asset in disease detection. Repeated periodic examinations help in detection of new unknown disease that was not present or not noted in earlier examinations.