Screening (medicine)

A coal miner completes a screening survey for coalworker's pneumoconiosis.

Screening, in medicine, is a strategy used to look for as-yet-unrecognised conditions or risk markers.[1][2][3] This testing can be applied to individuals or to a whole population without symptoms or signs of the disease being screened.

Screening interventions are designed to identify conditions which could at some future point turn into disease, thus enabling earlier intervention and management in the hope to reduce mortality and suffering from a disease. Although screening may lead to an earlier diagnosis, not all screening tests have been shown to benefit the person being screened; overdiagnosis, misdiagnosis, and creating a false sense of security are some potential adverse effects of screening. Additionally, some screening tests can be inappropriately overused.[4][5] For these reasons, a test used in a screening program, especially for a disease with low incidence, must have good sensitivity in addition to acceptable specificity.[6]

Several types of screening exist: universal screening involves screening of all individuals in a certain category (for example, all children of a certain age). Case finding involves screening a smaller group of people based on the presence of risk factors (for example, because a family member has been diagnosed with a hereditary disease). Screening interventions are not designed to be diagnostic, and often have significant rates of both false positive and false negative results.

Frequently updated recommendations for screening are provided by the independent panel of experts, the United States Preventive Services Task Force.[7]

  1. ^ "To Screen or Not to Screen? - The Benefits and Harms of Screening Tests". NIH News in Health. National Institutes of Health. March 2017. Archived from the original on 22 December 2017. Retrieved 12 January 2020. Screening tests are given to people who seem healthy to try to find unnoticed problems. They're done before you have any signs or symptoms of the disease.
  2. ^ O'Toole, Marie T., ed. (2013). Mosby's medical dictionary (9th ed.). St. Louis, Mo.: Elsevier/Mosby. Kindle loc. 145535. ISBN 978-0-323-08541-0. OCLC 788298656. screening, n., 1. a preliminary procedure, such as a test or examination, to detect the most characteristic sign or signs of a disorder that may require further investigation.
  3. ^ "screening, n.". Oxford English Dictionary. March 2017. Archived from the original on 11 June 2017. Retrieved 12 January 2020. ... 8. a. Medical examination of a person or group to detect disease or abnormality, esp. as part of a broad survey rather than as a response to a request for treatment.
  4. ^ O'Sullivan, Jack W; Albasri, Ali; Nicholson, Brian D; Perera, Rafael; Aronson, Jeffrey K; Roberts, Nia; Heneghan, Carl (11 February 2018). "Overtesting and undertesting in primary care: a systematic review and meta-analysis". BMJ Open. 8 (2): e018557. doi:10.1136/bmjopen-2017-018557. PMC 5829845. PMID 29440142.
  5. ^ O'Sullivan, Jack W.; Heneghan, Carl; Perera, Rafael; Oke, Jason; Aronson, Jeffrey K.; Shine, Brian; Goldacre, Ben (19 March 2018). "Variation in diagnostic test requests and outcomes: a preliminary metric for OpenPathology.net". Scientific Reports. 8 (1): 4752. Bibcode:2018NatSR...8.4752O. doi:10.1038/s41598-018-23263-z. PMC 5859290. PMID 29556075.
  6. ^ Screening and Diagnostic Tests at eMedicine
  7. ^ Hall, Harriet (2019). "Too Many Medical Tests". Skeptical Inquirer. 43 (3): 25–27.