Sunday 21 October 2018

Dr Ciara Kelly: What is the solution to health screening crisis?

Our health screening programmes are at real risk of being abandoned
Our health screening programmes are at real risk of being abandoned

Ciara Kelly

I've grave concerns about health screening in Ireland. Not just cervical cancer screening, but also breast cancer screening, colorectal screening, retinal screening - all of them. And not the concerns you might have - that our screening is terrible, has misled people, engaged in cover-ups and been embroiled in scandals. No, not that. My concern is that we're on a path that may actually lead to health screening here being abandoned.

I've worked in medicine for 20 years and I understand the limitations of screening. I understand that high-volume, broad-stroke testing has false negatives - tests that are marked normal but where an abnormality is, in fact, present. And also false positives - tests that are marked abnormal, but no actual abnormality is present, but women are unfortunately put through unnecessary further tests and lots of anxiety as a result.

These are significant limitations and every possible effort should be made to keep them to a minimum, but they'll always exist to some extent. No screening programme in the world has eliminated them - it's the nature of screening. But, more importantly, I understand the huge benefits of screening. I understand the benefit of having a test that's acceptable in terms of invasiveness, and that's relatively fast and cheap, so that the whole population can be tested in a timely and affordable way. And its central benefit - that it has reduced the incidence of cancer by up to two thirds, and has saved thousands of lives - is a vital public health service. Screening has stopped innumerable Irish people from dying of cancer.

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