A survey of participation in medical check-ups in 24,299 women in Germany

Background: In Germany, a biennial medical check-up (MC) has been available for individuals 35 and older since 1989. The medical check-up includes identification of cardiovascular disease risk factors, such as high blood pressure and cholesterol levels, and examinations for diabetes mellitus type 2, and kidney disease. We investigated participation in MC among women in Germany. Methods: In a 2004 German nationwide health survey, participation in MC, among other questions, was investigated among 24,299 women (20–74 years), with regard to age, marital status, education, socioeconomic status (SES) and region of residence (East or West Germany). Multivariable logistic regression was used to examine associations between these variables and participation in MC. Results: Of 19 351 responding women 35 or older, 34.2% attended yearly MC, 19.2% every two years, 23.4% irregularly and 23.2% never; the overall two-year participation was 53.4%. Participation at least every two years was highest among the 55–64 year-olds (64.6%) followed by the 65–74 year-olds (64.0%). In adjusted models, single women were less likely to have a MC at least every two years compared to married women (OR: 0.63, 95% CI: 0.57–0.71). Women living in East Germany were less likely to participate at least biennially (OR: 0.80, 95% CI: 0.74–0.85) then women in West Germany. No association between participation in biennial MC and education was found; however, women with low SES participated in biennial MC less often compared to women with high SES women (OR: 0.79, 95% CI: 0.71–0.88). Conclusion: Only about half of eligible women reported participating in biennial MC, with differences for age, region of residence, marital status, and SES. Systematic invitations may help to improve participation, but this is only indicted if screening is of high quality and effectiveness.