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MPs issue warning about the 'downsides' of screening for disease

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Patients are not being properly warned about the risks of screening for chronic diseases such as cancer, according to MPs.

Checking apparently healthy people for illnesses can lead to false results and leave the patient being given treatment – including major surgery – that they do not need, according to a new report published by the Commons’ Science and Technology committee.

“Like any medical intervention, screening carries both benefits and risks”

Andrew Miller

The report also raised concerns over the health check programme introduce in 2009 that offers patients a so-called “MoT” from the age of 40, warning it could be a waste of valuable NHS resources.

Around 11 million patients in England are invited for some form of screening every year, with the bill for breast, cervical and bowel cancer programmes coming in at around £348m – while a further £400m is spent on non-cancer testing.

But the committee found that while there are benefits to screening, public perception of the practice is so positive that it is difficult to convey the downsides.

Reforms have recently been made to breast cancer screening information to help patients make an “informed choice” about whether the test is right for them, but the committee was told that the leaflet “still does not fully explain the hazards of false positive diagnosis, ie mastectomy and radiotherapy being given unnecessarily”.

MPs called on the UK National Screening Committee, the government advisory group, to draw up general screening guidelines to ensure patients are given all the facts.

Committee chair Andrew Miller said: “Like any medical intervention, screening carries both benefits and risks, whether that is for breast cancer, for aneurysms or hypothyroidism in newborns.

Science and Technology Committee

Andrew Miller

“However, health screening is seen in such a positive light by the public that it can be challenging to convey the negative side of the equation,” he said.

“While screening can increase the likelihood of curing, preventing or delaying the progression of disease for some patients, for others it may lead to false results, misdiagnosis and unnecessary treatment,” he added.

“More needs to be done to ensure that both the benefits and risks are clearly, and even-handedly, communicated so that people can make an informed choice about whether screening is right for them,” said Mr Miller, who is Labour MP for Ellesmere Port and Neston.

The NHS Health Check programme – which is aimed at preventing heart disease, stroke, diabetes and kidney disease – was introduced five years ago without rigorous evidence and was not reviewed by the UK NSC because it is not classed as a screening programme, the committee found.

But the lack of scrutiny by the NSC gives rise to “serious questions” about quality of the evidence over whether it can achieve its aims, leaving MPs concerned it could be “wasting resources”.

Mr Miller added: “Developments in genetic science mean that it should soon become possible to target screening programmes directly at those most of risk of certain diseases.

“It is imperative that the UK National Screening Committee develops its capacity for horizon scanning and ensures that proven developments in screening are supported and implemented across the NHS,” he said.

 

 

  • 3 Comments

Readers' comments (3)

  • In my opinion if a screening programme is shown to save lives and lower the incidence of a particular disease in the population, then it's worthwhile. But yes of course patients should be informed of the pros and cons.

    As for the NHS health checks, it's an opportunity for patients to discuss lifestyle changes they might need / like to make that they otherwise wouldn't have sought advice about.

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  • Pussy

    I think they are afraid of not being able to cope with all the genuine positives! Let's be quite honest we've have a World Health Service now with National a thing of the dim n distant.

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  • michael stone

    This was being discussed rather well on Radio 4.

    It seems the latest generation of scanners can detect very small 'abnormalities', and as one doctor commented, the problem is that a few months later some of these tiny abnormal bits of tissue will have become nasty (say in patient no 1) while others will has disapperaed entirely (say in patient 2).

    There is currently no way of working out, which will turn out to be harmless, and which damaging: but, if you detect one, there is a sort of 'presumption that something should then be done' (and doing something which wouldn't have been necessary, is usually not ideal).

    The public debate on this one, is not likely to be fantastic, either, as it involves 'coping with probabilities', which isn't normally a human strong-point !

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