11.8 - Considerations in the Establishment of Screening Recommendations and Programs

To summarize, all of the following will be considered when making decisions about screening programs or guidelines. Are these factors considered in the ongoing discussions about mammography guidelines?

Patient/Community/Population Considerations

  • Acceptability/desirability by patient and community
  • The historical precedent for screening
  • The sufficient burden of disease

Epidemiological/Medical Considerations

  • Different populations have a distinct and different distributions of disease
  • The natural history of disease supports early detection
  • Availability of ‘adequate’ screening tests
  • Availability of and compliance with ‘effective’ treatment and follow up
  • Acceptability by the provider and health care system

Resource Considerations

  • Will of the political and healthcare system
  • Availability of resources - funds, services, transportation,…
  • Cost-effectiveness of screening