Over the course of a lifetime, you may be screened for a variety of diseases. We look at screening programs for bowel, breast and prostate cancer.
In 1968, heart attacks, strokes and other vascular diseases accounted for 56% of all deaths in Australia; by 2005, this had fallen to 35%.
Many GPs carry out informal or “opportunistic” screening for heart and circulatory disease risk. Regular blood pressure checks, blood tests to measure cholesterol and lipids (fats) and reviews of body mass index, together with reduced smoking rates, much improved treatment options for early stage disease and evidence-based advice, have resulted in marked decreases in potential years of life lost due to heart attacks, strokes and other diseases of the circulatory system.
This trend is encouraging, but there’s still room for further improvement in relation to prevention, early detection and treatment of these diseases.
Public health system criteria
- The condition to be screened for should be an important health problem - it must be known that it can be present in an early form without any symptoms.
- The test should be simple, safe, sensitive (few false negative results) and specific (few false positive results). The possible results of the test that are used to indicate the need for further testing or treatment should be clearly defined and widely agreed.
- Early treatment of the condition tested for must be proved to be effective in bringing about better outcomes by reducing mortality and improving quality of life.
- These better outcomes must clearly outweigh any potential harm to people from the screening, such as false positives leading to unnecessary psychological stress, invasive diagnostic tests and treatment with possible serious side effects.
- The proposed screening program would not use resources that could save more lives and prevent more suffering if used in other ways.
- The health system should ensure that positive screening test results can be promptly followed up – for example, colonoscopy following a positive bowel cancer test.
In your lifetime, you may well be screened for any one of these diseases – so it pays to understand the whys and wherefores.