Twenty-one percent of Rhode Island's adult population belonged to the highest risk class for not using the 6 kinds of preventive health care services (Figure 5): at least 75% of these had never had a pneumonia vaccination and had not had an influenza vaccination in the past year; at least 77% of those aged 50 or older had never had a sigmoidoscopy or a colonoscopy; 99% of the men aged 40 or older had not had a PSA test in the past 2 years; and at least 48% of women had not had a Pap test in the past 3 years or a mammogram in the past 2 years for women aged 40 or older. This evidence concerns the gene KLK3 and pneumonia.