Show Summary Details
Page of

How screening started 

How screening started
How screening started

Angela E. Raffle

, Anne Mackie

, and J. A. Muir Gray

Page of

PRINTED FROM OXFORD MEDICINE ONLINE ( © Oxford University Press, 2020. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 29 October 2020

This chapter explains how health screening began, how the aims have evolved, how evidence and organisation influenced matters, and how challenges in the future will give rise to continuing change. It begins with Gould’s address in 1900 to the American Medical Association and charts events that led, almost by accident, to the institution of comprehensive annual testing of healthy adults in the USA, and to 5 day hospital-based ‘Human Dry Dock’ screening for Japanese executives. Scientific challenge then came from two randomised control trials, which failed to find benefit, but by then screening had become an important commercial activity. Using the UK cervical screening programme as a case study, the chapter explores how the optimism of the 1960s led through disillusionment, then to programme organisation and, by the 1990s, an era of realism. Evolution of the Wilson and Jungner criteria as an aid for policy making is covered. A key challenge now is to ensure best value policy, high quality systematic programme delivery and informed choice in the face of commercial forces that lead to the glossing over of screening’s complexities and far reaching consequences.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.