Abstract


Screening is defined as a ‘test to detect potential health disorders or diseases in people who do not have any symptoms of disease’ (1). It is a method of detecting possible pathology in a pre-determined high-risk population to better inform decision making with regards to further investigations or management (2). It is not necessarily intended to be a means of diagnosis.

By offering screening to a population, often based on demographic factors including age or gender, the aim is to reduce the incidence of serious health problems at a late or symptomatic stage of disease. It is well documented that the introduction of screening programs has improved national mortality rates, globally. This is demonstrated well by the introduction of breast screening in various parts of the world. A study in Norway concluded that ‘After 15 years of follow up, a 43% reduction in mortality was observed among women who attended the national mammographic screening program in Norway (3). Blanks R G et al commented on a 21.3% reduction in mortality for women aged 55-69 years in 1998, when ‘compared to predicted mortality in the absence of screening or other effects’ (4). In April 2010 – a study in Canada found that ‘initiation of the screening program led to a significant reduction in breast cancer mortality within five years of its initiation’ (5). More locally in the MENA region, it is well identified that ‘mortality rates have declined with late detection of the disease dropping from 64% in 2009 to 16% in 2013’ (6). It goes on to champion screening services claiming ‘As in other countries, one of the most effective ways of lowering mortality rates from cancer can be to engage the public in an education campaign around possible signs or symptoms. This also includes engaging public health bodies in organising campaigns and funding for mammograms.