Cost-effective syphilis screening in military recruit applicants

A cost-effectiveness analysis of syphilis screening was performed. Strategi es included no screening, universal testing at military entrance processing stations, universal testing at basic training centers, and contracting cen tralized screening. Probabilities derived from data retained on recruit app licants from 1989 through 1991 (N = 1,588,143) and from the published liter ature were used. Cost estimates were derived from costs incurred by the mil itary and costs projected from implementing new strategies. Sensitivity ana lyses were performed. Modifying the existing contract for human immunodefic iency virus screening to include syphilis screening would maximize the effe ctiveness of screening at a cost to the Department of Defense of $9.52 per additional year of service received. The no-screening option was significan tly more cost-saving than the current method of testing, Syphilis is rare a nd treatable, and individuals with syphilis will be identified by other mea ns in many cases, Syphilis screening of recruit applicants at the military entrance processing stations should cease, saving the military $2,541,000 p er year.