Early detection – which can help with the decision?

Medical examinations are usually used to find the causes of specific ailments. However, a screening test is aimed at people without complaints. Your goal is to detect a disease at an early stage before it causes discomfort. This is useful in many cases, but sometimes not.

Recognizing illness early is only sensible if you can treat it better. The early knowledge and intervention should, therefore, have a health benefit. But like almost all medical procedures, screening can be useless or even harmful.

In some screening examinations, the advantages outweigh, in others rather the disadvantages, and some are controversial. It is, therefore, worthwhile to weigh the pros and cons of an investigation before deciding to participate.

Criteria for the evaluation of early detection examinations

Screening examinations are often referred to in the jargon as “screening” (from the English “to screen”). The World Health Organization (WHO) has established criteria for assessing screening tests. These may help in deciding whether or not to perform a particular investigation. The WHO criteria include:

It should only be studied for diseases with severe consequences so that the participants also have a clear health benefit.
The screening method for early detection should be sufficiently reliable and not harmful.
There must be a treatment available that will be more useful if given early. So before complaints occur, in which one would go anyway to the doctor.
People should be informed neutrally about the screening, so they know enough to weigh the pros and cons for themselves personally.

Early detection cannot prevent diseases

The goal of early detection is to detect conditions before they cause discomfort. Some screenings also look for precursors of states that are then treated. However, the screening test does not influence whether one develops a disease or precursor or not.

Precursors do not always become diseases

Due to early detection examinations, many people can be treated, even though they would have developed no illness at all. Because many disease precursors do not necessarily develop further or can even regress themselves without causing any problems.

No medical test is perfect

The medical tests used in screening tests often do not provide a reliable diagnosis. Usually, at first, only abnormalities are sought, which then have to be clarified with the help of further examinations.

Often, the critical test result turns out to be a false alarm. This can lead to unnecessary worries and sometimes lead to follow-up examinations that would not have been necessary.

Sometimes it also happens that a test in a sick person shows no abnormalities, so overlooks a disease. Or the test result is not clear, so it lies in the borderline between normal and conspicuous findings.

Early detection does not provide definitive security
For complaints that are worrying, it is essential to take them seriously and have them undergo a medical examination – even if nothing was found at the last screening test.

Ask the doctor

If it is difficult to decide for or against a screening test, it may be helpful to seek medical advice. Here are some questions you could ask:

How likely is it that this disease occurs at my age?

Would I have long-term health benefits if the disease is detected early? For example, is there proof that I could live longer?

What adverse effects may be associated with the examination, possible follow-up and treatment and how often do they occur?

How often and at what intervals do I have to go for early detection to benefit from it?

How often does the test trigger a false alarm and how often does it overlook a condition?

Do not burden with things that have not happened yet

Today, there are a variety of screening tests. Some of them are considered very useful, others are scientifically not well studied or not useful, but are still offered and sometimes advertised loudly. This can give the impression that there is a disease waiting to be protected on every corner.


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