Making Sense of Screening
Scientists, clinicians and medics have come together to express their concerns that public expectations about screening don’t match what screening programmes can deliver.
High profile cases, such as Kylie Minogue’s treatment for breast cancer and Jade Goody’s death from cervical cancer, have made screening an emotive and politicised subject. They have led to demands (and political promises) that more sections of the population should be included in screening programmes, for longer and more frequently. They have prompted complaints that screening programmes are dictated purely by financial calculations. Amidst all this, the limitations and possible harms from screening have been largely lost from public view and this has led to unrealistic expectations of what screening can deliver.
By addressing misconceptions about how screening works, its limitations and the calculation of benefits and harms, the scientists and clinicians hope to bridge the gap between the active debates of the scientific community and the concerns raised by the public.
In the guide, Making Sense of Screening, they explain that screening:
- rarely benefits all sections of the population and it can have negative effects, so it needs to be targeted at those most likely to benefit.
- can identify some of the people who have a disease but it cannot prevent disease.
- cannot give you a ‘yes’ or ‘no’ answer and an ‘all clear’ does not mean you will not go on to develop the disease.
Comments:
Anne Mackie, Director of Programmes, UK National Screening Committee: “I very much welcome this guide. People often think screening is instinctively a good thing; how could finding something early possibly be otherwise? It is crucial that, as the number of screening programmes offered rises, everyone understands what screening can and cannot do for them and so is able to decide for themselves.”
Professor Sir Muir Gray, Chief Knowledge Officer of the NHS: “Sense About Science has hit the nail on the head again; this is accurate and clear and should be read by all health professionals as well as by members of the public. Those who run screening programmes have a difficult job and better understanding about the risks, harms and benefits of screening will make their job easier, not more difficult.”
Síle Lane, Sense About Science: “Sense About Science this year experienced a huge rise in public concerns about screening. Many people are worrying that they are being denied important healthcare. No wonder they felt like that. When we reviewed internet forums and health stories, we found that there was hardly any reference to the calculations of benefits and harms, which specialists kept telling us were vital to deciding who to screen and for what.”
Martyn Lobley, GP and columnist: “This report should be left lying around in bus stations, fast food joints and by supermarket checkouts so that the people who really need screening, the “Not Worried Well” who don’t see their GP from one year to the next, might be persuaded to get with the programme.”
Hedley Glencross, The Institute of Biomedical Science: “Screening has become a high-profile issue and is the topic of much public debate, not least due to the individual stories that have been widely reported in the popular media. Screening though is often a poorly understood healthcare initiative whose benefits and limitations need to be explained.”
Professor Peter Furness, President, Royal College of Pathologists: “Screening for disease looks like a really simple concept, but actually it’s rather complicated. If you don’t know the difference between a screening test and a diagnostic test, you should read this booklet.”
Caroline Wright, Head of Science, PHG Foundation: “This is a timely report; advances in genetics are offering us exciting new opportunities for improved screening, but it is important to be clear that - just like other tests - genetics is not a crystal ball and the risks and benefits must always be carefully weighed up.”
Joe O’Meara, Government Affairs Officer, The Association of Clinical Biochemistry: “There is a great deal of discussion going on about screening both in the public arena and in private. I believe that this publication provides the factual information needed to inform those discussions and to help people make the best decisions for themselves on the matter.”
Coverage
Marie Stopes International Charity warns over screening issues
The Scotsman Warning of limitations and harm of screening for diseases
Mediwatch Blogspot Making Sense of Screening, by Sense About Science
BMJ Report calls for public education on screening to ensure more realistic expectations
Phg foundation New publication to help the public understand screening
Times Online Breast screens blamed for unneeded ops
Medical News Today DIY Health Screening Not Necessarily A Good Idea
The Prostate Cancer CharityThe Prostate Cancer Charity comments on the launch of a new guide to screening
Last updated: November 13 2009
