Criteria for population screening

The term screening is used in medicine to refer to diagnostic investigations performed in the population with the aim of identifying individuals with a disease or who are at risk of developing it. The World Health Organisation (WHO) has identified 10 criteria for a disease to be diagnosable through mass screening.

1. The pathological condition must be an important health problem.

2. There must be a therapy for the pathology sought.

3. Facilities for diagnosis and treatment must exist.

4. There must be a latent stage of the disease.

5. There must be a test or examination to ascertain the pathology in the latent phase.

6. The test must be well accepted by the population.

7. The natural history of the disease should be properly understood.

8. There must be agreement on treatment protocols and on whom to treat.

9. The total cost of discovering a case should be economically balanced in relation to overall medical expenditure.

10. The screening process should be prolonged over time.

Screening procedures involve medical examinations of the entire population in individuals who normally have no symptoms or clinical signs of disease. The purpose of screening is to detect diseases in a community at an early stage and in the absence of symptoms, thus enabling timely therapeutic interventions to reduce mortality and/or disease complications. An example of a screening programme implemented in Italy since the 1990s is neonatal screening, which is carried out in all newborns with the aim of early detection of congenital diseases. To date, extensive neonatal screening in Italy looks for the possible presence of 49 different diseases, including cystic fibrosis, congenital hypothyroidism, phenylketonuria and other congenital defects of intermediate metabolism.

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