Screening in Public Health and Clinical Care: Similarities and Differences in Definitions, Types, and Aims – A Systematic Review

Abstract

Introduction: The concept of screening can be many times misleading to many people. This may be partly due to the way screening is described and explained in textbooks and journal articles. Aim: To review prominent public health and epidemiology textbooks, dictionaries, and relevant journal publications for definitions and examples of screening, with the aim of identifying common usages and concepts, as well as sources of potential confusion. Materials and Methods: Commonly available epidemiology and public health textbooks and peer reviewed journals were searched for definitions and examples of screening. The search located seven journal articles, 10 textbooks, and one dictionary. The search platforms used were Pubmed, BIOSIS, EMBASE, Medline-OVID and Scopus under the Epidemiology and Biostatics subject head listed with Life Sciences. Results: Descriptions of screening give varying emphasis to whether it is a test or a program, the aims of screening, the setting in which it is conducted, eligibility criteria, who initiates and who is intended to benefit and whether the condition being screened is an infectious or chronic disease or a riskelevated state. Four essentially different ‘types’ of screening are described, using seven terms and occasionally contradictory examples. The detection of asymptomatic infectious cases is gradually changing from screening to surveillance as part of infection control. Conclusion: Voluntary screening programs rely on high participation to be effective and support and trust of the public are essential for the continued success of the public health profession. Consistent terminology is important for patients, providers and policymakers to understand what screening is and is not. Clear definitions are needed if we are to evaluate and communicate the risks and benefits of screening in public health.

Keywords

• clinical practice
• public health screening programs
• surveillance