The pros and cons of screening
Population screening programmes can cause harms as well as benefits, which need to be weighed up by the UK National Screening Committee (UK NSC).
Population screening
Screening is the process of identifying apparently healthy people who may have an increased chance of a disease or condition.
The screening provider then offers further tests and/or treatment. This is to enable choices and reduce associated problems or complications.
Screening should always be a personal choice. Accurate, balanced information should be provided at each step.
Screening is not always the answer
The UK runs screening programmes that help millions of people every year to live longer, healthier lives and make informed decisions about their health. All these programmes have been recommended by the UK NSC because evidence shows that most people will benefit from them.
No screening test is perfect and there will always be some incorrect results. These ‘false negative’ or ‘false positive’ results can be harmful, as someone may either be falsely reassured or be unnecessarily worried and perhaps have invasive or harmful tests or treatments which they do not need.
False negative: someone with a negative screening result who does have the target condition
False positive: someone with a positive screening result who does not have the target condition
As screening programmes offer screening to large numbers of people every year, the impact of incorrect results and unnecessary treatments could quickly add up. This could harm a lot of people and potentially put a strain on NHS diagnostic and treatment services.
So while screening can have huge benefits, it’s not always the answer to helping people with a particular health condition and resources might be better used elsewhere. For instance, it might be more effective for the government to invest in treatment services, or awareness campaigns so that people with symptoms visit their GP.
Weighing up the pros and cons
What level of harm (physical or psychological) do you think a screening programme should be permitted to cause? In an ideal world, nobody would be harmed but in practice that’s not possible.
For instance, what if there was a good, accurate test for a particular condition but treatment is often ineffective? Or there might be a great treatment but a poor test which means many people will be offered treatment who do not need it.
Here’s a short video which explains many of the pros and cons of population screening. It shows what the UK NSC weighs up when deciding whether it can recommend a new screening programme.