Urinary tract infection is probably the commonest bacterial infection. Although primary prevention is preferable to early diagnosis and treatment, in practice it is limited to the avoidance of unnecessary instrumentation of the urinary tract. Research on the defensive mechanisms of the urinary tract may widen the scope of primary prevention.
Iron deficiency anaemia is a very common condition in the United Kingdom. Prevalence is greatest amongst women of child-bearing age and elderly men and women. Detection is easy, accurate and fairly cheap by means of a simple battery operated haemoglobin meter. Anaemia is not a disease entity in itself, but a result of various causes. Thus, its morbidity rate and mortality rate are the collective ones for all the many underlying causes.
Chronic bronchitis and emphysema account for 7 per cent of all deaths in men and 3 per cent in women between the ages of 45-64. Simple bronchitis can be diagnosed by asking about persistent expectoration, or more specifically by measuring the volume of sputum a specimen of which, if purulent, will also permit the diagnosis of mucopurulent bronchitis. Obstructive bronchitis can be diagnosed by spirometry or by measuring peak flow and forced expiry time. These cheap, accurate and simple tests can be carried out by the General Practitioner.
Deaths from ischaemic heart disease are increasing amongst the early middle-aged in many countries. Over one quarter of all deaths amongst British males under the age of 45 are caused by arteriosclerotic heart disease and there is ample social and economic justification for attempting to detect asymptomatic and early disease — but only if effective preventive treatment is available.
In July 1965, the Office of Health Economics held a colloquium on Surveillance and Early Diagnosis in General Practice at Magdalen College, Oxford. It was apparent from the discussion at this meeting that General Practitioners believed that if they were to act effectively in this field, they had to have clear cut information on current screening methods and the impact of early diagnosis of disease on the long term health of the patient. As a result of this view an Advisory Committee was set up by the Office of Health Economics.