Screening Programs

Screening is offered to people who do not have a known symptom or diagnosis, with the goal of identifying who may benefit from a closer assessment. A screening result changes the level of attention required; it does not establish what disease is present. A sound screening program needs more than an available test. Early detection must offer a meaningful benefit, the test must be acceptable and sufficiently accurate, and a reliable pathway must exist for diagnostic assessment and treatment. Without follow-up, screening can create anxiety and false reassurance without improving care. Diagnostic assessment begins when symptoms, functional change, collateral concern, or an abnormal screening result requires explanation. Screening asks, “Who needs a closer look?” Diagnostic assessment asks, “What is causing this person’s findings?” Sensitivity and specificity describe how a test performs in a defined population. They do not turn one person’s result into a diagnosis. A positive screen means further assessment may be needed; a negative screen does not erase a strong clinical concern.