What screening does
- DOI:
- 10.1093/med/9780198805984.003.0003
This chapter gives a deeper understanding of screening, and of the diverse consequences it brings. It illustrates the overdetection problem with reference to mammography breast screening programmes, and explains the ‘popularity paradox’ that this leads to. In the early days, the simplistic notion that screening must automatically be beneficial meant that people only asked ‘why are we not doing it?’ Later scientific challenges brought a new question, ‘How do we tell if screening succeeds in reducing risk?’ This served well as a driving force for better evaluation, but it ignored the need to assess harmful consequences. Growing experience has revealed the need to ask ‘what are all the consequences?’ Different observers see some consequences more starkly than others depending on their viewpoint. This chapter explains why it is important to consider a complete overview of an entire programme and to recognise that overdetection, overtreatment and underdetection, are inevitable features even when screening is delivered to a high quality.
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.
