Screening for Disease

Screening for Disease
Although many individuals and organizations may endorse the goal of screening programs, the details and implementation are often controversial. For some types of screening, it can be quite challenging to weigh the human and economic costs and benefits and determine a clear recommendation. For instance, in an article in the New England Journal of Medicine, Dr. Michael Barry (2009) indicates that “serial PSA [prostate-specific–antigen] screening has at best a modest effect on prostate-cancer mortality during the first decade of follow-up. This benefit comes at the cost of substantial over-diagnosis and overtreatment. It is important to remember that the key question is not whether PSA screening is effective but whether it does more good than harm.”
This week’s Learning Resources include articles about screening programs for four different diseases that contain potentially controversial recommendations. Select a disease and examine the epidemiological evidence to assess a recommendation for screening guidelines. In addition, you will consider possibilities for furthering policy to promote population health related to this disease.
To prepare:
• Review the four articles concerned with screening and public policy listed in this week’s Learning Resources. All four articles contain potentially controversial recommendations for screening and prevention.
• Select one article on which to focus for this paper
• Analyze how the epidemiologic data could be used to formulate policy for improving population health.

RESOURCES:

Creighton, P., Lew, J.-B., Clements, M., Smith, M., Howard, K., Dyer, S., Lord, S., & Canfell, K. (2010). Cervical cancer screening in Australia: Modelled evaluation of the impact of changing the recommended interval from two to three years. BMC Public Health, 10, 734–747.

Hugosson, J., Carlsson, S., Aus, G., Bergdahl, S., Khatami, A., Lodding, P., & … Lilja, H. (2010). Mortality results from the Göteborg randomised population-based prostate-cancer screening trial. Lancet Oncology, 11(8), 725–732.

HealthMap. (2007). Retrieved from http://www.healthmap.org/en

This website tracks, maps, and describes current disease outbreaks around the world, along with sources of information about them. It provides a valuable picture of global public health issues.

Centers for Disease Control and Prevention. (2011). A framework for program evaluation. Retrieved from http://www.cdc.gov/eval/framework/index.htm

The CDC provides this framework for program evaluation.

Association for Community Health Improvement. (2006). Planning, assessment, outcomes & evaluation resources. Retrieved from https://web.archive.org/web/20130709124030/http://www.communityhlth.org/communityhlth/resources/planning.html

Explore the many resources available for program evaluation.