Table 1.
Criteria for assessment of screening
| Wilson and Jungner | Crossroads 99* |
|---|---|
| Knowledge of disease | Knowledge of population and disease |
| Condition must be important problem | Burden of target disease should be important |
| Target population or population at risk identifiable | |
| Recognisable latent or early symptomatic stage | Considerable level of risk or latent or preclinical phase |
| Natural course of condition, including development from latent to declared disease, should be adequately understood | Natural course (from susceptibility to precursor, early disease, and advanced disease) should be adequately understood |
| Knowledge of test | Feasibility of screening procedures |
| Suitable test or examination | Suitable test or examination |
| Test acceptable to population | Entire screening procedure acceptable to population |
| Case finding should be continuing process and not “once and for all” project | Screening should be continuing process and encompass all elements of screening procedures |
| Treatment for disease | Interventions and follow up |
| Accepted treatment for patients with recognised disease | Interventions that have physical, psychological, and social net benefit available |
| Facilities for diagnosis and treatment available | Facilities for adequate surveillance, prevention, treatment, education, counselling, and social support available |
| Agreed on policy concerning whom to treat as patients | Consensus on accepted management for those with positive test results |
| Cost considerations | Societal and health system issues |
| Costs of case finding (including diagnosis and treatment of patients diagnosed) economically balanced in relation to possible expenditures on medical care as whole | Costs should be balanced in economic, psychological, social, and medical terms and with healthcare expenditures as whole |
| Appropriate screening services accessible to entire population without adverse consequences for non-participants | |
| Appropriate confidentiality procedures and antidiscrimination provisions for participants and non-participants |
*
Ethical, legal, and sociobehavioural issues are considered across all domains. Screening should be considered within framework that recognises fundamental human rights.