Making Sense of Screening

Weighing up the benefits and harms of health screening programmes.
Public expectations about screening don’t always match what screening programmes can deliver.

Published: 3 July 2015 (2nd edition)
All our guides are date stamped and reflect the scientific findings and knowledge available at the time of publication.

Making sense of screening pdf

A negative screening test result means that someone is low risk for the disorder being screened for, not no risk. It’s important to remember that screening tests are designed for people who have no symptoms. If someone develops symptoms – even if a recent screening test was negative – more accurate, diagnostic tests should be considered.

Dr Margaret McCartney

GP

Did you Know?

As tests become more accurate and pick up tiny aberrations, it is clear that very few of us are completely normal. Even though they are healthy, many people have ‘abnormal’ variations if subjected to a CT scan of the brain or endoscopy of the stomach.

background

Public expectations about screening don’t always match what screening programmes can deliver. Magazines and online discussions carry many personal stories of people who believe they were saved, especially by cancer screening, and of people who might have died because of a lack of screening. Letters to newspapers complain that screening programmes are dictated purely by financial calculations. Confusingly, another group of stories protest about the failure of screening to detect a friend’s or a relative’s disease. Amidst all this, the specific benefits of screening programmes and the sensitive calculation of these against possible harm have been largely lost from public view.

partners

This guide was produced in collaboration with The Association for Clinical Biochemistry and Laboratory Medicine, the Institute of Biomedical Science and The Royal College of Pathologists. New edition printed in 2015 with support from The Royal College of Pathologists and the Institute of Biomedical Science.

Making Sense of Screening partner logos: The Association of Clinical Biochemistry and Laboratory Medicine, Institute of Biomedical Science, Royal College of Pathologists

What’s the problem this guide is addressing?

The benefits and harms of some screening programmes are in dispute among scientists and policymakers. The statistics about who benefits and who is harmed by breast cancer screening, for example, are being actively debated. But for most people, it’s surprising just to learn that there are limitations as well as potential downsides to screening. It is important to know about these, both to be properly informed about screening you might be invited to take part in and to understand why screening programmes are offered to some parts of the population and not others.

impact

Making Sense of Screening was launched at a public discussion with the Royal College of Pathologists and again at the Royal College of GP’s annual conference in Scotland. This meant it reached a wide audience in the medical arena, while coverage in the Sunday Times and the Scotsman increased the public impact.

Links to the guide are featured on NHS evidence and the NHS screening portal. The guide has also been widely distributed; we have received requests for copies from a number of groups including patient advocate groups, a prostate cancer charity and a lecturer at Leicester University who is using it as part of a training session for medical students.