Should we abandon annual physical examination? – A meta-analysis of annual physical examination and all-cause mortality in adults based on observational studies

• Published in: Preventive medicine Vol. 161; p. 107130
• Main Authors: Pathak, Rashmi, Kang, Di, Lu, Yuanyuan, Mansuri, Fahad, Kasen, Stephanie, Deng, Yunlong, Chen, Henian
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.08.2022
• Subjects: All-cause mortality; Annual physical examination; Hazard ratio; Meta-analysis; Observational study; Observational study; All-cause mortality; Annual physical examination; Hazard ratio; Meta-analysis
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2022.107130

Several meta-analyses based on randomized clinical trials data have failed to find an association between the annual physical examination (APE) and reduced mortality; however, no comparable meta-analysis based on observational data exists. We conducted a meta-analysis of observational studies comparing APE versus non-APE in adults for all-cause mortality. English-language searches of four databases (PubMed, CINAHL, EMBASE, and Google Scholar) between the years 2000 to 2019 yielded seven observational studies that investigated APE versus non-APE in healthy adults in relation to all-cause mortality. Random effects models were used to calculate pooled hazard ratios and 95% confidence intervals (CI), and to incorporate variation between studies. During follow-up periods that ranged from two to 25 years, there were 35,055 deaths among 633,957 participants. APE was significantly associated with a 45% lower hazard of all-cause mortality, with pooled hazard ratio of 0.55 (95% CI 0.48 to 0.64, P < 0.01) for all participants. This meta-analysis of seven observational studies in the past 20 years provides evidence of an association between APE and a lower hazard of all-cause mortality, a finding that contrasts with findings based on meta-analyses of randomized clinical trials data. Nonetheless, at present the evidence available about the effectiveness or ineffectiveness of APE on all-cause mortality still needs further study. •Existing clinical trials data have failed to find an association between the annual physical examination and mortality.•Our study provides evidence of an association between annual physical examination and a 45% lower hazard of mortality.•At present, the available evidence on whether annual physical examination is associated with mortality is inconclusive.•The association between annual physical examination and mortality still needs further study.