Will routine physical examination detect syphilis?

In most cases, syphilis testing will not be included in the common entry physical examination, the unit's annual basic welfare package, and the individual's routine basic physical examination.

A while ago, I helped my elders choose a routine physical examination package for the elderly. I checked out seven or eight basic models with prices ranging from 300 to 800. The blood items included covered at most liver and kidney function, blood lipids and blood sugar, and preliminary screening of common tumor markers. Even hepatitis B only had basic tests for surface antigens, let alone special tests for sexually transmitted diseases such as syphilis and HIV. In fact, in essence, the positioning of routine physical examinations is universal basic health screening. It is necessary to balance the coverage of the population, cost and actual demand. If all infectious disease tests are added in one go, the cost of a set of basic physical examinations will increase by at least one-third. For the vast majority of people who do not have high-risk exposure risks, it is a completely unnecessary expenditure and may also bring unnecessary privacy concerns.

Of course, there are no exceptions. If you choose a mid-to-high-end physical examination package worth more than 1,000 yuan, or an entry-level physical examination in special industries such as early childhood education or direct contact with imported food, some of them will include four infectious diseases (including syphilis, AIDS, hepatitis B, and hepatitis C) as required items. Pre-operative and pre-blood donation screenings will also routinely check for syphilis, but these scenarios do not fall into the category of "routine physical examinations" that we talk about every day.

I have seen related discussions in the field of public health before. Some scholars believe that the latent infection rate of sexually transmitted diseases in recent years is not low. Early screening and early treatment can avoid a lot of subsequent irreversible physical damage. They call for syphilis testing to be included in the popularization of routine physical examinations. However, there are many voices of opposition. Firstly, they feel that it unnecessarily increases the anxiety of ordinary people. Secondly, such testing involves extremely strong personal privacy. If it is added to the unit package, it is easy to cause privacy leaks. Both sides are reasonable, and there is currently no unified adjustment opinion.

When I helped a dermatologist at a community free clinic, I met a young man in his 20s who had had unprotected high-risk sex before. He thought he had just had an annual physical examination at his workplace and there was nothing wrong with him, so he ignored him. However, he developed chancre and went to the hospital in a panic for a checkup. Only then did he realize that the previous routine physical examination did not include syphilis at all, which wasted half a year of intervention time. In fact, a separate syphilis antibody test only costs a few dozen yuan, and the local CDC can even provide free confidential screening. If you have really engaged in high-risk behavior, don’t wait for a routine physical examination to find out. It’s more reliable to take the initiative to get tested. If you have daily needs and want to add items, it is very simple. When you go to the physical examination, just tell the front desk that you want to add syphilis special items. Don’t be embarrassed. Now, the results of such items are strictly confidential in regular physical examination centers, and no one else can get the report except you.