I see medical screening as a way of identifying a population group that are at increased risk of developing a particular disease or condition, with a view to reducing their chances of further complications by direct medical/non medical interventions.
Almost two years ago I did a study on Alzheimer’s Disease (AD) in which had to critically appraise some literature with regards to the implementation of population screening for the disease. Dementia is an important health problem and AD makes up a significant proportion of all dementia’s (~60%). With the ageing population in the UK and therefore rising prevalence of AD, the annual cost of care for the disease is estimated at £17bn, which is more than heart disease (£4bn), stroke (£3bn) or cancer (£2bn) and is projected to rise further1. This would seem good enough ground to at least consider the potential benefit of screening?
The dilemma is twofold however. This is because currently, AD can only be diagnosed in its late stages, the point at which treatment has no chance of reversing the damage. Novel treatments are in the pipeline but it is hard to test how well these actually work without a population group that has been identified (through accurate screening) who are at risk or at the early stages of AD. So, the main opposition to screening for AD seems to be that that there is no cure and therefore resulting in unnecessary anxiety and other factors we’ve discussed, but scientists argue the need for an ‘at risk’ population to be able to develop these drugs. The question is how do you go on from here?
On the one hand, screening could potentially benefit a vast amount of people and even help with the development of novel treatment in this case that will serve future generations even more. On the other hand, as with any screening procedure the potential for false positive and negatives alike are an issue that can’t be overlooked as causing undue ‘harm’ in the way of unnecessary treatment, stress and anxiety.
