Center Quality Assurance and Care Committee. Also included in that review are items such as the appropriateness of the useof anti-infective agents. A certified medical records consultant randomly reviews approximately 20 percent of our records for accuracy and completeness. MEDICAL FINDINGS Patient Participation: The participation of many excellent 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 personnelinvolved 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 (corrected for nonavailability) were: Rongelap Utirik 1988 86% 84% Comparison 68% 1989 82% 91% 62% 1990 88% 85% 65% The percent of the eligible population efamined on at least one occasion during the last fpur-year period was: Rongelap Utirik Comparison 95% 98% 90% These figures do not include severalf persons residing outside the MarshallIslands. Mosifexposed personsin this category have medical examinations arranged through a local physician [by the Department of Energy or the Marshal§ Islands Medical Program. The acceptance rate for mammography among eligible women was 100%. For sigmofdoscopy, about 75% of age-eligible persons elfcted to undergo this procedure on a regular basi Overall Survival: After 37 years there continues to difference between the survival curves of dither the _ high-exposure Rongelap group or the low—exposure Utirik group and the age- and gendergmatched unexposed Rongelap population selected in 1957 (Fig. 1). Estimates of the survival distripution by the actuarial life table method were analyaed by the Mantel-Cox and Breslow statistics for t@sting the equality of the survival curves. The “p" Jalues for the two tests were 0.66 and 0.82, respectively, for the Rongelap and Comparison group, ang 0.43 and