Module 5– Screening
by Huiling Zhou – Number of replies: 0Advantages and Disadv
Module 5– Screening
by Huiling Zhou – Number of replies: 0Advantages and Disadvantages of Screening
Screening is a necessary component of promoting health because it is a proactive measure. This measure aims at preventing the development of a particular disease, especially chronic diseases. Such diseases are the leading causes of financial struggles to keep up with medications and treatments because diseases prognosis might devastatingly impact on health. Therefore, screening is necessary as it prompts early intervention measures before the disease progresses to advanced stages and it aims to reduce costs and improve health outcomes. However, the appearances of false positives have impacted screening measures negatively. Therefore, this discussion will evaluate the advantages and disadvantages of screening.
Healthcare professionals advocate for screening based on the idea that early detection of the disease at its pre-symptomatic stages can lead to easier treatment and better outcome. Vujosevic et al. (2020) highlighted early detection of diabetes can be managed through diet compared to medication, thus saving the individual from associated suffering once the disease advances. Also, screening not only looks for diseases but also associated risk factors for various conditions. For example, a high BMI is a significant risk factor for heart disease. In this case, screening is advantageous because the patient will be advised accordingly based on the screening results. Providers can develop a physical exercise routine and diet with patients to address the BMI factor and reduce the likelihood of heart disease. Consequently, screening is beneficial as it helps manage the condition before it spreads. For example, the recent pandemic in places like schools was easily managed, highlighting cases of infection before it spread to other students. Therefore, screening, especially for infectious diseases, is advantageous to promote public health and prevent a health crisis.
As much as screening is a recommended measure, it also has its drawbacks. This is seen in those false negatives and false positive results. In false negative result, it shows a negative result from a particular disease while the person has the condition. On the other hand, false positives confirm the condition, but the individual does not have it. Yong et al. (2022) explained that when this happens, an individual may be subjected to further unnecessary tests, some of which are invasive or assured they do not have the condition for it to develop, thus beating the ideology of early detection for prompt interventions. Kraus et al. (2021) questioned the necessity of screening for some diseases because technological advancements have improved treatment measures regardless of the diagnosis. Therefore, one may argue that at some point, screening may be ineffective; instead, healthcare resources should be directed to treatment and awareness of various risk factors and how to stay healthy.
Conclusively, one should weigh the advantages and disadvantages of screening before participating in one. Although screening has its advantages and being essential to detect certain cancers, the false results have created a barrier to screening uptake because of the associated psychological and physical harm. For example, invasive diagnostic tests after a false positive can be traumatizing. It will be highly appreciated that screening tests can protect individuals who may have limited accessibility to healthcare or other necessary resources, especially cancer screening such as PAP smear, colonoscopy, and mammogram. At the same time, healthcare systems can invest more in research and technology advancement to ensure treatments in various disease stages, so that patient’s prognosis can aim for full recovery.
References
Kraus, S., Schiavone, F., Pluzhnikova, A., & Invernizzi, A. C. (2021). Digital transformation in healthcare: Analyzing the current state-of-research. Journal of Business Research, 123, 557-567. https://doi.org/10.1016/j.jbusres.2020.10.030
Vujosevic, S., Aldington, S. J., Silva, P., Hernández, C., Scanlon, P., Peto, T., & Simó, R. (2020). Screening for diabetic retinopathy: new perspectives and challenges. The Lancet Diabetes & Endocrinology, 8(4), 337-347. https://doi.org/10.1016/S2213-8587(19)30411-5
Yong, S. E. F., Wong, M. L., & Voo, T. C. (2022). Screening is not always healthy: an ethical analysis of health screening packages in Singapore. BMC Medical Ethics, 23(1), 1-21. https://doi.org/10.1186/s12910-022-00798-5Module 5 Discussion
by Vivian Revilla Rodriguez –
It is better to be cautious than to regret; likewise, it is better to monitor our health systematically. This way, we will be more confident of identifying any medical issues. Screening involves tests to determine if an asymptomatic patient has a potential risk of any disease. Colonoscopy, mammography, Pap smears, or cervical cytology are examples of essential screening methods in preventive medicine. While traditional diagnosis focuses on symptoms, screening targets presumably healthy population groups and identifies specific diseases promptly (Pienaar et al., 2019).
Some of the advantages of screening include reducing medical problems, decreasing mortality, and preventing complications. When a disease is detected in its early stages, there are greater chances of curing it, extending the patient’s lifespan, and improving their well-being. Additionally, screening can prevent the use of invasive and costly long-term treatments. Therefore, screening impacts the quality of life and economic sustainability (Pienaar et al., 2019; Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 2023).
Colorectal cancer is the second most common cause of death in the United States, and in 85% of cases, this disease is detected in very advanced stages. That is why the 5-year survival rate is only 50%. As a screening method, colonoscopy represents a crucial key to reducing complications and mortality associated with this type of cancer (Zhang et al., 2020). Cervical cancer is another condition that can be detected early. Thanks to screening programs implemented in the United States since the 1950s, the prevalence and mortality of this disease have significantly decreased. However, gaps in access to these tests persist, so incidence rates remain high (Fontham et al., 2020; Bedell et al., 2019; Fuzzell et al., 2021). Randomized studies and those related to breast cancer mortality have shown a relationship between increased mammography screening and a significant decrease in breast cancer mortality (Duffy et al., 2020).
Despite their numerous advantages, screening tests also come with disadvantages. One example is the false positive, which involves incorrectly classifying a person as having a disease they do not have. False negatives can be even worse because they lead to not treating someone at risk. These screening tools can also lead to overdiagnosis and overtreatment, as there is a possibility that the patient will never develop symptoms. Additionally, they can cause anxiety and mental health issues in patients awaiting results (Pienaar et al., 2019).
Questions about ethics, politics, and social issues have arisen concerning screening. The need for informed consent for these tests has been debated. Furthermore, only some have equal access to screening. Research has shown variations in disease prevalence between resource-poor areas where screening tests are unavailable and more developed environments where the opposite is true. The high cost of early detection programs is undeniable, and it is often questionable whether allocating resources to screening is justified when more urgent primary care needs also require them (Pienaar et al., 2019).”
Nevertheless, the prevailing criterion is to invest in screening programs. This is due to treating diseases promptly and their impact on global public health.
References
Bedell, S. L., Goldstein, L. S., Goldstein, A. R., & Goldstein, A. T. (2020). Cervical cancer screening: past, present, and future. Sexual Medicine Reviews, 8(1), 28-37.
Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (2023). What Is Breast Cancer Screening? Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/breast/basic_info/scree…
Duffy, S. W., Tabár, L., Yen, A. M. F., Dean, P. B., Smith, R. A., Jonsson, H., … & Chen, T. H. H. (2020). Mammography screening reduces rates of advanced and fatal breast cancers: Results in 549,091 women. Cancer, 126(13), 2971-2979.
Fontham, E. T., Wolf, A. M., Church, T. R., Etzioni, R., Flowers, C. R., Herzig, A., … & Smith, R. A. (2020). Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA: A Cancer Journal for Clinicians, 70(5), 321-346.
Fuzzell, L. N., Perkins, R. B., Christy, S. M., Lake, P. W., & Vadaparampil, S. T. (2021). Cervical cancer screening in the United States: Challenges and potential solutions for underscreened groups. Preventive Medicine, 144, 106400.
Pienaar, K., Petersen, A., & Bowman, D. M. (2019). Matters of fact and politics: Generating expectations of cancer screening. Social Science & Medicine, 232, 408-416.
Zhang, J., Chen, G., Li, Z., Zhang, P., Li, X., Cao, X. … & Zhang, L. (2020). Colonoscopic screening is associated with reduced Colorectal Cancer incidence and mortality: a systematic review and meta-analysis. Journal of Cancer, 11(20), 5953.
