Screening

Question 1

What is screening?

Answer 1

The aim of screening is to identify individuals with disease at an earlier stage, with better prognosis and earlier treatment. This is specially important for those who are asymptomatic.

Question 2

What type of prevention is screening?

Answer 2

Secondary prevention

Question 3

What are the pregnancy screenings?

Answer 3

Foetal anomaly screening programme
Infectious diseases
Sickle cell and thalassemia

Question 4

What are the principles of a screening programme?

Answer 4

Condition should be a health problem
There should be an accepted treatment for patients with a recognised disease
There should be a suitable test or examination
Facilities for diagnosis or treatment should be available
Test should be suitable and acceptable to population

Question 5

What is the criteria for evaluating screening programme?

Answer 5

UK National Screening Committee which evaluates a screening programme based on:
The condition
Test
Treatment
Programme
Implementaiton

Question 6

What is lead time?

Answer 6

Duration of time between detection of disease and clinical presentation.

Question 7

What is lead-time bias?

Answer 7

Over-estimation of survival time with screening due to point of diagnosis being earlier but dying at the same age as if they were not detected with screening,.

Question 8

What is length-time bias?

Answer 8

Over-estimation of survival bias due to being more likely to detect cases that are asymptomatically slowly progressing and less severe disease, while fast-progressing diseases are detected when giving symptoms.

Question 9

Who is less likely to engage with screening?

Answer 9

Low socioeconomic status
Ethnic minority
Transgender
Disabilities

Question 10

What is the barriers to screening?

Answer 10

Fear
Cultural barriers
Travel
Language
Moved address.

Question 11

What is the female specific screening?

Answer 11

Cervical cancer screening from age 25-64 years old
Breast cancer screening from age 50-70 years old

Question 12

What is the male specific screening?

Answer 12

Abdominal aortic screening aneurysm, for men over 65 years old

Question 13

What is the universal screening offered to adults in the NHS?

Answer 13

Bowel cancer screening for those aged 60-74 years old
Diabetic eye screening for those aged 12 and over
Newborn blood spot test screening
Newborn hearing screening
Newborn and infant physical examination

Question 14

What should the nature of the condition be in an ideal screening programme?

Answer 14

It must be a significant health problem
Well understood in terms of disease course
Has detectable risk factors.

Question 15

What should the nature of the test be in a screening program are?

Answer 15

Simple and precisely validated screening test
Test should be acceptable to public
Distribution of test values should be known

Question 16

What should the nature of the treatment in a screening test be?

Answer 16

Effective treatment with evidence of early treatment leading to better outcomes.
Agreed policies of who should be offered treatment
Management of the condition should be optimised before the screening is created

Question 17

When is a screening programme implemented?

Answer 17

Evidence with RCT that the screening programme is effective in reducing mortality/morbidity.
There should be evidence that the programme is acceptable to the public
The benefits should outweigh the harm
The opportunity cost must be balanced to healthcare spending (e.g should be cost-effective)

Question 18

What are the issues with screening?

Answer 18

False positive which leads to unnecessary and harmful treatment
Exposure to radiation with specific treatments