Conclusion
Screening is more complex than it first appears and requires considerable resources for sustainability and impact. It is critical to identify a health problem that has a significant effect on the selected target population, that can be treated, and to prevent progression to more advanced disease.
Benefits versus harms need to be balanced, including costs to the healthcare system and value for money. Costeffectiveness does not equate to affordability nor does it solve the problem of competing health needs. There is no ‘one size fits all, even with cervical cancer screening which has a proven track record of being effective at reducing morbidity and mortality. Compliance with screening programmes is essential for success, and this requires attuned and sensitive messaging that provides true risks and benefits as well as a programme that is acceptable to the screened population.
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