Screening: when is it appropriate and how can we get it right?

ABSTRACT

Technological and other scientific advances have made it possible to screen for ever larger numbers of molecules and see inside the human body with a level of detail that was once unimaginable. Where there is good evidence that detecting a condition early will, overall, be beneficial for those who are screened, then it may be appropriate to design and implement a formal screening programme. However, just because something can be done does not mean that it should be done as screening may bring benefits as well as harm. In this brief the authors start by explaining the core components of a screening programme, highlighting that, while seemingly simple, putting together all elements of a screening programme is very complex. They then ask when screening should be done, emphasizing the continued relevance of Wilson & Jungner’s screening principles. In addition, they examine the pressures to implement screening and, where screening is inappropriate, suggest ways to reduce it. When screening is appropriate, evidence is presented on how to achieve optimal results. This brief is an essential reading for anybody involved in the decisions on screening or its provision.