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Sobering notes on screening

I remember lots of criticisms when Alistair Burns was accused of pushing the idea of screening for dementia. Re: There is no evidence base for proposed dementia screening | The BMJ

What he and others were keen to promote, was awareness in the general population and amongst doctors, especially GPs, to symptoms which might indicate that an individual was developing dementia or some other pathology causing change in cognitive function and maybe other cerebral functions. The wish was, and is, to move from a position of turning a blind eye, to one of informed investigation and therapy where this is appropriate.

Increased rates of diagnosis of dementia are almost certainly beneficial. Primary Care Dementia Data, February 2023 - NHS Digital

This has resulted by improved case finding, rather than whole population screening

Working with our local PPG (Patients’ Participation Group) we were told recently to be pleased that the Practice is about to beginning screening for breast cancer. Recent studies, reported in the lay as well as academic press, suggest this may not be a good investment:

Some cancer screening tests may not extend lifespans, study finds | Cancer | The Guardian

Estimated Lifetime Gained With Cancer Screening Tests: A Meta-Analysis of Randomized Clinical Trials | Cancer Screening, Prevention, Control | JAMA Internal Medicine | JAMA Network

Resources devoted to a fashionable but useless initiative, would be better used elsewhere. It is not easy to steer a ship when everyone knows what is right!


Each week we post a blog from David Jolley where he shares his personal views on relevant subjects.

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