ONE OF the screening tests that has been used to measure the extent of communicable syphilis in a population is the premarital syphilis serology that is mandated by law in most states. Approximately 4 million serologies are performed annually in the United States for this purpose.1 In New York City, according to the Office of the City Clerk, 57,994 marriage licenses were issued in 1976. Therefore, about 116,000 premarital syphilis tests were performed. For some time, the Bureau of Venereal Disease Control of the New York City Health Department has been exploring whether this screening test has a meaningful impact on syphilis control.
For a screening program to be considered cost-effective, the disease screened should be of serious or catastrophic consequence and easily preventable or treatable, and the cost of the screening test itself should be negligible. Screening for hypertension and glaucoma fulfills these requirements well. On the other