Table 1

Consolidated screening principles

Screening principles
Disease characteristicsThe condition sought should be an important health problem
There should be a recognisable latent or early symptomatic stage
The natural history of the condition, including development from latent to declared disease, should be adequately understood
The target population for screening should be clearly defined (eg, with an appropriate target age range), identifiable and able to be reached
Test characteristicsThere should be a suitable test or examination with all key components specific to the test being accurate (sensitivity, specificity and positive predictive value) and reliable or reproducible
The test should be available and acceptable to the population
Intervention characteristicsThere should be an available and accepted treatment for patients with recognised disease
There should be an agreed policy on who to treat as patients
Programme characteristicsThe expected range and magnitude of benefits and harms for participants and society should be clearly defined and acceptable
Case-finding should be a continuing process
Ethics of screeningNon-maleficence and beneficence: the programme should be supported by high-quality scientific evidence that the overall benefit of the screening programme outweighs its potential harms.
Justice: The cost of case-finding (including diagnosis and treatment of patients diagnosed) should be economically balanced in relation to possible expenditure on medical care
Respect to autonomy: There should be effective methods for providing screening participants with informed choice, promoting their autonomy and protecting their rights