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What screening is, and is not 

What screening is, and is not
What screening is, and is not

Angela E. Raffle

, Anne Mackie

, and J. A. Muir Gray

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date: 24 October 2020

This chapter reviews the different ways in which the term ‘screening’ has been and is used, and defines the meaning used throughout the rest of the book. Growth of screening programmes in the twentieth century led to a range of activities which vary widely in purpose and process, from bloodspot tests in newborn babies, through to whole body scans for the wealthy worried well. This chapter explains the different kinds of testing done on healthy people, and how these differ from diagnostic tests for solving problems that patients bring to clinicians. It explains where screening fits in the pathway of disease development. It describes the basic system that makes up a screening programme as opposed to just a screening test. It explains, using infant phenylketonuria as a case history, why screening needs to be delivered as a proper programme if it is to successfully achieve risk reduction. We describe the variation in screening delivery across different countries and emphasise that this book focuses on systematic screening programmes, aimed at risk reduction for the screened individual, based on sound evidence that harm, benefit and affordability are well balanced, and delivered to pre-agreed policy and standards.

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