M101 Public Health Screening Flashcards
What are the three different levels of prevention?
Primary – preventing onset of disease
Secondary – preventing progression of disease (early diagnosis and treatment)
Tertiary – reducing disability and suffering from disease
What percentage of cancers can be prevented by not smoking?
at least 40%
How is HbA1c measured?
a sample of blood will be taken, usually from the arm.
What is the purpose of screening tests?
they sort out apparently well persons who probably have a disease from those who probably do not
What data might screening identify?
risk factors, genetic predisposition / susceptibility, and precursors, or early evidence of disease
What are the aims of screening tests?
Better prognosis / outcome for individual
Protect community from contagious disease
To select out unhealthy/unfit people (for certain jobs)
Selection of healthy individuals
Rational – more efficient allocation of resources
Research (e.g. on natural history of disease)
What are the different types of screening?
Mass or population
Multiple or multiphasic
Targeted
Case-finding or opportunistic
What happens during mass or population screening?
screening of the whole population (cancer)
What happens during multiple or multiphasic screening?
the use of two or more screening tests (to detect two or more diseases) on the same occasion (diabetes, hypertension)
What does targeted screening involve?
the screening of groups with specific exposures (HIV, HBV, HCV)
What does case-finding or opportunistic screening involve?
screening patients who consult a health practitioner for some other purpose (Chlamydia)
What are the WHO criteria for population-based screening otherwise known as?
the Wilson and Junger criteria
What are the medical WHO criteria for population-based screening?
the condition should be an important health problem
the natural history of the disease should be adequately understood
there should be a recognizable latent or early symptomatic stage
there should be a safe, suitable and acceptable screening test or examination
What are the political WHO criteria for population-based screening?
test must be quick / easy to administer /
non-invasive / inexpensive
What are the healthcare system WHO criteria for population-based screening?
facilities for confirming the diagnosis and follow-up should be available
there should be an accepted treatment or effective intervention for patients with recognized disease
there should be an agreed policy on whom to treat
treatment started at an early stage should be of more benefit than treatment started later
the cost of case-finding (including test/diagnosis/treatment) should be economically balanced in relation to possible expenditure on medical care as a whole
case finding should be a continuing process and not a ‘once for all’ project
What is the NHS policy on breast cancer screening?
women aged 50-70 years invited once every 3 years (women >70 can request/self-refer)
What is the NHS policy on cervical cancer screening?
all women aged 25-64 years (to check the health of cells in the cervix)
25-49 years invited once every 3 years, and those aged 50-64 invited every 5 years
What is the NHS policy on bowel cancer screening?
faecal occult blood test for persons aged 60-74 years every 2 years (home screening kit)
What is the NHS policy on abdominal aortic aneurysm screening?
is offered to all men in their 65th year of age
men over 65 can self-refer
What two conditions are all neonates screened for?
phenylketonuria
congenital hypothyroidism
What is the NHS policy on the elderly for general check ups?
patients aged ≥75 years have a general assessment every 12 months
What is the NHS policy on cardiovascular risk factor screening?
newly registered patients and patients not seen within 3 years
What is the NHS policy on bladder cancer screening?
for those with occupational exposure
What is the NHS policy on HIV screening?
all women receiving antenatal care
