Screening

Question 1

Screening programme solely for males

Answer 1

Abdominal aortic aneurysm (AAA)

• Age 65
• Ultrasound

Question 2

Screening programmes in the UK

Answer 2

1. New-born screening programme
2. New-born blood spot programme
3. New-born hearing screening programme
4. NHS diabetic eye screening programme (age 12 diabetic patients)
5. NHS bowel cancer screening programme (56y/o)
6. NHS cervical screening programme
7. NHS foetal anomaly screening programme
8. NHS infectious diseases screening programme
9. NHS sickle cell and thalassaemia screening programme

Question 3

Criteria for appraising the viability, effectiveness and appropriateness of a screening programme

Answer 3

1. Condition
   - The condition needs to be understood with a detectable risk factor
   - Epidemiology, incidence, prevalence & natural history needs to be understood
2. Test
   - There should be a simple, safe, precise and validated screening process
3. Treatment
   - There should be an effective treatment with evidence of early treatment leading to better outcomes
4. Programme
5. Implementation
   - 4&5 together
   - - There must be RCT evidence that the programme is effective in reducing mortality and morbidity
   - - There should be evidence that the whole programme is acceptable to professionals and public
   - - The BENEFIT SHOULD OUTWEIGH THE HARM
   - - Opportunity cost of the programme should be economically balanced in relation to health care spending
   - - There must be a plan for QUALITY ASSURANCE and adequate staffing and facilities

Question 4

Who is less likely to engage with screening

Answer 4

1. Low socio-econoic status/living in deprivation
2. Ethnic minorities/migrants
3. Transgender
4. Disabilities

Question 5

Barriers to cancer screening uptake

Answer 5

1. Fear
2. Cultural barriers - stigma of cancer
3. Language
4. Easy to ignore letters
5. Lack of transport
6. Embarrassment
7. Lack of awareness
8. Psychological
9. Require child care