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Screening Whitelist

Lest Bandolier seems to be nihilistic, a charge that some have levelled after the publication of the Bandolier screening Blacklist , we now publish a Screening Whitelist - tests for which there is adequate evidence of effectiveness. Perhaps there should also be a Screening Greylist of screening tests currently being offered to the population but which are now being reviewed by the MRC and by the R&D Programme.

Whitelist

Child health screening is being investigated in the Hall Report, the national review of child health screening services, and so is not part of the Whitelist at present as the report is expected to be published later in the year. Neither is screening of the elderly covered in this list at present. Screening here is concentrated on people aged between 20 and 65 years of age. The Whitelist is quite short to start, but argued suggestions for additions to, or deletions from the list would be welcomed.
  • Breast cancer screening for women over 50 years - but see [1 & 2].
  • Cervical cancer screening for women over 20 years - not more often than every five years for maximum cost-effectiveness.
  • Screening for high blood pressure according to the British Hypertension Society guidelines.
  • Identifying cigarette smokers and advising them of the benefits of stopping smoking.
This list does not cover case finding, the systematic identification of individuals at high risk - for example identifying the first degree relatives of people who have had a myocardial infarction under the age of 50 years.

Reference:

  1. CJ Wright, CB Mueller. Screening mammography and public health policy: the need for perspective. Lancet 1995 346: 29-32.
  2. Correspondence. Lancet 346: 436-9.



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