Table 2

How growth monitoring performs against the criteria for a screening programme (based on Wilson and Jungner, with modifications proposed by UK national screening committee 1998)

The condition
(1)Should be an important health problem2-150
(2)Epidemiology and natural history of the condition should be adequately understood and there should be a detectable risk  factor, disease marker, latent period, or early symptomatic stage (Y)
(3)All cost effective primary prevention interventions should have been implemented (NA)
The test
(4)A simple, safe, precise and validated screening test2-150
(5)Distribution of the test values should be known and a suitable cut off level agreed2-150
(6)The test should be acceptable to the population (Y)
(7)Agreed policy on further diagnostic investigation of positive test results2-150
Treatment
(8)Effective treatment or intervention; early treatment leading to better outcomes than late treatment (Y)
(9)Evidence based policies on who should be offered treatment and the appropriate treatment (Y)
(10)Clinical management of the condition optimised before introduction of screening (N)
The screening programme
(11)Evidence that the screening programme is effective in reducing mortality and morbidity (N)
(12)Complete screening programme (test, diagnostic procedures, treatment/intervention) must be clinically, socially, and  ethically acceptable to health professionals and the public (U)
(13)Benefit should outweigh physical and psychological harm (U)
(14)Opportunity cost should be economically balanced in relation to expenditure on medical care as a whole (U)
(15)A plan for managing and monitoring the screening programme and agreed quality assurance standards (N)
(16)Adequate staffing and facilities for testing, diagnostic treatment, and programme management (U)
  • First annual report of the National Screening Committee. London: HMSO, 1998.

  • 2-150 Discussed in text.

  • Y, yes; N, no; U, unknown; NA, not applicable.