Screening : between hope and hype

Screening (or population screening) involves the medical examination of individuals who exhibit no health problems with the aim of detecting disease, or an hereditary predisposition to disease, or risk factors that can increase the risk of disease. The government has great expectations of screening, as do caregivers, private individuals, and other groups within the healthcare sector. Developments appear to be moving fast: new forms of screening are either being brought on line within the healthcare sector or are being marketed by commercial organisations.
The focus on novel screening techniques is tied in with changes within the healthcare sector itself. It is also in keeping with many people’s need for reassurance on matters of personal health. The rapid growth in the range of various health checks and self-testing kits is also in keeping with a health service that is determined by market forces, with an emphasis on freedom of choice and individual responsibility.
These developments involve both opportunities and threats. The opportunities derive from the fact that new forms of screening can help people to live more healthily, and avoid symptoms and consequences of disease. There are also threats, because it is by no means a foregone conclusion that the benefits of screening will always outweigh the ever-present drawbacks. There is a tendency to introduce screening before it has been properly researched.
It was in this regard that the Minister of Health, Welfare and Sport approached the Health Council of the Netherlands for advice. There are three central issues. The Minister wants a clear idea of forthcoming developments in the area of screening over the next few years. He would also like to know whether the existing criteria for responsible screening still form a sound basis for the evaluation of those developments and of how they are dealt with in other countries. Finally, he has asked for an indication of the significance of developments in this area, in terms of the role and responsibility of government.

Committee

• Prof. H.R. Büller, Professor of Internal Medicine, Amsterdam University Medical Centre, chairman
• Prof. J.M. Bensing, Professor of Medical Psychology, Utrecht University Medical Centre
• Prof. P.J.E. Bindels, Professor of General Practice Medicine, Amsterdam University Medical Centre
• Prof. M.C. Cornel, Professor of Community Genetics, Amsterdam Free University MedicalCentre
• Prof. C.M. van Duijn, Professor of Epidemiology and Biostatistics, Erasmus Medical Centre,Rotterdam
• Prof. J.C.J. Dute, Professor of Medical Law, Erasmus University, Rotterdam
• Prof. Y. van der Graaf, Professor of Clinical Epidemiology, Utrecht University Medical Centre
• Prof. J.D.F. Habbema, Professor of Operations Research, Erasmus Medical Centre, Rotterdam
• Prof. G.A. den Hartogh, Professor of Ethics, Amsterdam University
• Prof. H.S.A. Heymans, Professor of Paediatric Medicine, Amsterdam University Medical Centre
• Prof. B.W.J.H. Penninx, Professor of Psychiatric Epidemiology, Amsterdam Free University Medical Centre
• Dr. D. Stemerding, Medical Sociologist, Twente University, Enschede
• Prof. F.R. Rosendaal, Professor of Clinical Epidemiology, Leiden University Medical Centre
• Prof. A.L.M. Verbeek, Professor of Clinical Epidemiology, St Radboud University Medical Centre, Nijmegen
• Dr. Y.A. van Duivenboden, Health Council, The Hague (from December 2007), advisor
• P.C. Groeneveld, Ministry of Health, Welfare and Sport, The Hague, advisor
• Dr. P.G. Reulings, Health Care Inspectorate, Amsterdam, advisor
• Dr. W.A. van Veen, Health Council, The Hague, advisor
• Dr. W.J. Dondorp, Health Council, The Hague, scientific secretary
• L.F. Stultiëns, Health Council, The Hague, scientific secretary