Screening and prevention

5 important questions on Screening and prevention

Screening (secundaire preventie)

- Different definitions
- Process of actively seeking to identify a disease or pre-disease condition in people who are presumed and who presume themselves to be healthy.

Population screening vs. family history/target group screening

population screening: aimed at detecting problems in the general population
target group screening: screening targeted at individuals with a family history of a particular disease

Factors moderating the impact of screening

- Most peple cope well with the screening process, but there are some subgroups of people who may be more susceptible to adverse effects of screening
- factors that moderate negative impact of screening (both family history and general population screening:
* bad communication, information, counselling by health care provider
* demographic characteristcs (younger age, low education and low SES)
* pre-existing anxiety and worry!!
* prior expectations, beliefs and personality
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Commercial genetic screening

- 'Direct-to-consumer' genetic tests do not make place within a context of regulation and awareness of its limitations
- Tests yield a high rate of false-positive results and an array of further tests
--> more harm than good (no in-depth counselling)

Ethics of commercial screening tests

- substantial increase in health care costs
- more worries
- marketed as 'safe' and 'harmless'
- in US often sponsored by a trusted medical organization (in NL mag dat niet)
- before screening risks should be discussed and downstream health care use: appropriate counselling!
- evidence does not support that patients engage in healthy behaviour after screening results
- companies and sponsoring hospitals benefit

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