Screening

Question 1

screening

Answer 1

catch early, do something about it and prevent worse symptoms

Question 2

health warning about screening programmes

Answer 2

all screening programmes do some harm
most do considerable good
NHS prevents commercial motives

Question 3

who are screening programmes for?

Answer 3

coordinated sets of services for a defined population

they have to do more good at a reasonable cost - not everyone can be screened

Question 4

who decides who should be screened?

Answer 4

there is a defined population but it is a voluntary decision

Question 5

what is screening?

Answer 5

process of identifying apparently healthy people who may be at increased risk of a disease or condition
targeted population are sieved

Question 6

when should screening not be done?

Answer 6

when there is no treatment/ nothing that can be done as there is no point

Question 7

when should screening be done?

Answer 7

when someone who is positive can be offered information on further tests and appropriated treatment to reduce their risk and any complications arising from the condition/ disease

Question 8

what is prevalence?

Answer 8

number of individuals within given population with target condition

Question 9

what is sensitivity?

Answer 9

screening’s ability to refer individuals who do have the condition for further assessment

Question 10

what is specificity?

Answer 10

the measure of the screening’s ability to NOT refer individuals without the target condition

Question 11

what is a false positive?

Answer 11

individuals who are referred for further assessment but do not have the target condition

Question 12

what is a false negative?

Answer 12

individuals who are NOT referred for further assessment but do have the target condition

Question 13

how to plan a screening programme?

Answer 13

1. condition sought should be an important health problem that is treatable
2. there is an accepted treatment for the recognised disease available facilities for diagnosis
3. recogniseable latent or early symptomatic phase -e.g. cervical, bowel or breast cancer
4. suitable test or examination - thousands of people being tested
5. must be acceptable to the population
6. natural history of the disease well understood
7. agreed policy on whom to treat - widespread
8. cost of case finding (diagnosis and treatment) should be economically balanced in relation to expenditure on medical care
9. case- finding should be a continuing process

Question 14

diabetic retinopathy screening

Answer 14

effective treatment
larger focus in pregnancy
cost-effective

Question 15

abdominal aortic aneurysm

Answer 15

healthy aorta diameter just smaller than 3cm
around 6000 deaths each year
2% of deaths in 65 and older men
risk increases with age
protocols following screening

Question 16

risk factors for AAA

Answer 16

male 
hypertension
smoking
family history
age 
structural protein/ collagen disease - hypermobility of blood vessels

Question 17

most common cancers

Answer 17

breast
prostate
lung
bowel

Question 18

risk factors for breast cancer

Answer 18

female
increasing age
previous history
proven benign breast disease in past
not breastfeeding long term
HRT
family history
having no or few children 
having children over 30
early puberty
late menopause
obesity - for post-menopausal women only
high consumption of alcohol

Question 19

genetic risk of breast cancer

Answer 19

2 breast cancer genes have been identified - BRCA1 and BRCA2

not all breast cancers are due to genetics, other types of breast cancer are not genetic related

Question 20

cervical cancer screening

Answer 20

cervical cancer is totally preventable
screening every 3-5 years from 25-64
treatable disease
early detection increases survival rate
not all cervical cancers are caused caused by HPV
having many sexual partners or having a partner who has had several sexual partners increases risk