What is screening? When should a screening programme be set up? Alexa Lilley and Ruth Bell discuss the issues that arise
- By: Alexa Lilley, Ruth Bell
Primary prevention is better than cure. But if this is not possible, is time a good thing to capitalise on? Secondary prevention through screening encompasses the idea that the health service seeks healthy people, rather than patients spontaneously seek doctors.
An early diagnosis has intuitive appeal, because starting treatment early may be more effective or less invasive.w1 This may seem straightforward in the context of curing someone before they experience symptoms but raises important ethical questions, different from in most other clinical practice, because we look for ill health without being invited to do so by the patient.w1 Does screening deny the patient the perception of being healthy? Can we treat what we find? Does screening do more harm than good?w2
Screening is a public health service that we are all offered at some point, despite sometimes being unaware of it—for example, testing for phenylketonuria, hypothyroidism, and congenital hip dislocation