Question

Following a pilot programme in Waitemata, a national screening programme to detect bowel cancer early is being introduced in New Zealand. People aged 60-74 years will be invited to take part in the bowel screening programme, starting from 2017.

(a) An anticipated benefit of the screening programme is a reduction in deaths from bowel cancer among people who take part in the screening programme. This benefit is more likely to occur if the programme is of high quality. Discuss how the programme should be evaluated, including the key factors you would measure in the evaluation of the screening programme.

(b) Screening programmes are known to have potential harms as well as benefits. It is important that people are given information about these potential harms and benefits before they decide whether to take part in screening. What information would you provide to people about the screening programme?

Answer 1

a) As bowel or colorectal cancer is the third most common cancer world wide ,here people aged 60 - 74 years are invited for screening program to cause a reduction in the death among people from bowel cancer. For this, the screening programme should be of the highest quality and for endoscopic procedures like diagnostic colonoscopy, key performance indicators ( KPI) can be used to monitor quality. colonoscopies are performed by screening accredited colonoscopists who maintain high KPI standards. Megapixel definition Colonoscopes improve adenoma detection without compromising other measures of endoscope performance.

Established organized screening programs produce high quality data about their performance and program structure, providing a basis for other screening programs to be developed.

b) To inform people about benefits of screening program like, finding out whether they have a health problem or an increased risk of a health problem can help them make better informed decisions about their health. Screening can reduce the risk of developing a condition or its complications.

To inform people about the harmful effects of screening program like

1. The paradox of screening.​​​​​​

2. False positive tests lead to discomfort, costs and risks from additional diagnostic and therapeutic procedures. False negative tests lead to a sense of security and delays in seeking medical help when symptoms develop.

Finally after saying about both the benefits and harmful effects of screening program to the people and concluding that benefits from many screening maneuvers are uncommon and modest and they must be balanced against the potential harms to help patients decide whether to proceed with testing.