1
Q
What is screening?
A
- testing (Qs, physical exams, labs) asymptomatic people
Examples:
- “annual physical”
- Periodic (colonoscopies, gynecological exams, mammograms, PSA)
2
Q
What is the purpose and potential benefits of screening?
A
- detect diseases that are better treated before signs and symptoms show up and prevent people from suffering with or dying from them
- use knowledge of risk factors for disease to prevent or decrease the burden of the disease by modifying the risk factors
3
Q
For best results of screening “DISEASE” should be:
A
- a significant public health problem
- common and/or significant morbidity and/or mortality - treatable with these stipulations
- the potential for cure increases with early detection
- treatment is easily available
4
Q
For best results of screening “TEST” should be:
A
- sensitive to pre-clinical disease
- safe
- inexpensive
- easily accessible/available
- lead to demonstrated improved health outcomes
5
Q
Define pseudodisease?
A
a condition detected by screening that does not require treatment because it will not adversely affect the patient’s life
6
Q
What are the types of pseudo-disease?
A
Type I: conditions that might not progress to symptomatic disease and may even regress
Type II: slowly progressive disease (conditions with a long detectable preclinical phase)
7
Q
What are the harms of screening?
A
- harms of tests (radiation, perforation from colonoscopy, cost, time)
- false positives:
- psychological burden
- further testing (over-testing)
- over-treatment (even safe treatments impose burden, financial and otherwise)
