HaDSoc Session 6 Flashcards
What is opportunistic case finding in disease presentation?
Health professional takes opportunity to check for potential conditions on presentation of symptoms for a different disease
What is screening?
Systematic attempt using simple, rapid and cheap tests to detect an unrecognised condition in apparently well people
Describe the process of diagnosis.
Presentation –> Hx, examination and tests –> disease/no disease –> Tx that pt is willing to take risks of due to self-identification of problem
Describe the process of screening.
Rapid, cheap test –> screen +ve = high risk, -ve = low risk –> diagnostic tests if +ve –> disease/no disease –> Tx if necessary
What is the purpose of screening?
Give a better outcome in comparison with spontaneous presentation or opportunistic case finding
What screening and diagnostic tests are used for breast cancer?
Mammography and fine needle aspiration
Who is screened for breast cancer and how often?
50-70 y.o. Females, 3 yearly
What screening and diagnostic tests are used for bowel cancer?
Faecal occult blood test and colonoscopy
What are the screening and diagnostic tests used in AAA?
Single US scan and surgery is appropriate
Who is screened for bowel cancer and how often?
60-69 y.o. Males 2 yearly
What are the advantages of AAA screening?
Decreases risk of death from rupture by ~50%
What are the disadvantages of AAA screening?
Of 238 invited only one would present in the next 10 years, Tx may result in death anyway, reduced QoL with Tx, intolerable anxiety of having untested AAA
Why is there currently no national screening programme for prostate cancer, breast cancer
Could do more harm than good
What disease criteria must be met for a screening programme to be introduced?
Important, epidemiology and natural Hx well understood, early detectable stage, cost-effective primary interventions fully explored
What test criteria must be met for a screening programme to be introduced?
Simple, safe, precise, valid and acceptable to population
What must be known about a test used for screening in order for an agreed cut-off and policy of further investigation to be defined?
Distribution of test values
What is a true +ve screening result?
Disease present and +ve test
What is a false +ve screening test?
Disease absent, +ve test
What is a false -ve screening result?
Disease present and -ve test
How is disease detected?
Spontaneous presentation, opportunistic case finding, screening