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Detecting disease before symptoms begin: the blemished promise of cancer screening 

Detecting disease before symptoms begin: the blemished promise of cancer screening
Chapter:
Detecting disease before symptoms begin: the blemished promise of cancer screening
Author(s):

J. Frank

, R. Jepson

, and A. J. Williams

DOI:
10.1093/med/9780198725862.003.0008
Page of

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date: 29 October 2020

In Chapter 2, the example of a widely-used screening test for prostate cancer (PSA) was used to illustrate one of the most profound turnarounds in medical thinking about prevention in recent decades. This was spurred on by the first-ever publication of a controlled trial of a cancer screening test, which demonstrated strong evidence that the test does more harm than good. This chapter analyses that case study in detail, as a worked example of how to assess the quality of any controlled trial of screening, purporting to provide evidence of the efficacy, effectiveness, and clinical efficiency of a screening programme, especially for cancer.

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