Center Quality Assurance and Care Committee. Also included in that review are items such as the appropriateness of the use ofanti-infective agents. A certified medical records consultant randomly reviews approximately 20 percent of our records for accuracy and completeness. Staff: The Marshall Islands Medical Program is deeply indebted to the many outstanding physicians who, despite the inevitable personal inconvenience, participated in the medical team visits of 1988-1991. It is fair to say that they are the heart of the program. Drawn from excellent medical centers through the United States and from private practices, these physicians provide the program with a wide range of up-to-date clinical experience and perspective that contribute to better patient care. The physicians and other medical team personnel involved in the 1988-1991 missions are listed in Appendix A. The clinical role of team physicians is the delivery of primary and subspecialty care. By selecting subspecialists who remain active in general medicine for this role, the medical program benefits from in-depth knowledge of their specialty. The following medical specialties and subspecialties were represented in 1988-1991: Internal Medicine Pediatrics Cardiology Rheumatology Radiology Gastroenterology Hematology Endocrinology Surgery Ophthalmology Obstetrics/Gynecology Pulmonary Medicine Emergency Medicine Oncology MEDICAL FINDINGS Patient Participation: The participation of many excellent medical specialists undoubtedly has been a major factor in the acceptance of the Marshall Islands Medical Program by the population it serves, for utilization of the program is entirely voluntary. The percentof personsin the exposed and Comparison groups who appear for examination remains high. For the current reporting period the annual acceptance rates (corrected for nonavailability) were: 1988 Rongelap 86% Utirik 84% Comparison 68% 1989 82% 91% 62% 1990 88% 85% 65% 1991 85% 87% 60% The percent of the eligible population examined on at least one occasion during the last four-year period was: Rongelap Utirik Comparison 95% 98% 90% These figures do not include several persons residing outside the Marshall Islands. Most exposed persons in this category have medical examinations arranged through a local physician by the Department of Energy or the Marshall Islands Medical Program. The acceptance rate for mammography among eligible women was 100%. For sigmoidoscopy, about 75% of age-eligible persons elected to undergo this procedure on a regular basis. Overall Survival: After 37 years there continues to be litle difference between the survival curves of either the high-exposure Rongelap group or the low exposure Utirik group and the age- and gender-matched unexposed Rongelap population selected in 1957 (Fig. 1). Estimates of the survival distribution by the actuarial life table method were analyzed by the Mantel-Cox and Breslow statistics for testing the equality of the survival curves. The “p” values for the two tests were 0.66 and 0.82, respectively, for the Rongelap and Comparison group, and 0.43 and