. 2011 Mar 17;19(Suppl 1):S6–S44. doi: 10.1038/ejhg.2010.249

Box 1. Criteria for assessment of screening.

Wilson and Jungner	Crossroads 99a
Knowledge of disease	Knowledge of population and disease
Condition must be an important problem.	Burden of target disease should be important.
	Target population or population at risk identifiable.
Recognizable 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 the population.	Entire screening procedure acceptable to the population.
Case finding should be a continuing process and not ‘once and for all' project.	Screening should be a continuing process and should encompass all elements of screening procedures.

Treatment for disease	Interventions and follow-up
Accepted treatment for patients with recognized 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 a whole.	Costs should be balanced in economic, psychological, social, and medical terms and with health-care expenditures as a whole.
	Appropriate screening services accessible to the entire population, without adverse consequences for non-participants.
	Appropriate confidentiality procedures and antidiscrimination provisions for participants and non-participants.

Ethical, legal, and sociobehavioral issues are considered across all domains. Screening should be considered within a framework that recognizes fundamental human rights.