Risk Factor Screening versus Screening for Early Disease

Risk factor screening is screening similar to cholesterol screening. It is testing that is done in the absence of disease that can tell who is at risk for a disease and who is at lesser risk for the disease. When it comes to cholesterol screening, it can be done at any age, including adolescence but is most often done after the age of forty. What’s important to remember is that the screening for the risk factor does not usually screen for the disease itself but instead for those things that lead to the disease.

Screening for early disease includes Chest Xrays, cervical cancer and breast cancer screening tests. Such tests are directly designed to screen for a particular disease but to catch the disease as early as possible so that disease survival is maximal. Colonoscopy can also be categorized as a test that screens for early disease.

Both types of screening can be done using a systematic program, in which people are invited to participate in the screening test. Large numbers of individuals are screened at a time. Screening can be done using an opportunistic program, in which the person is seen for another reason and then is drawn into being screened for the disease. Open access screening is done when the population being screened is completely self-selected and there is no medical intervention without request of the patient.

In one study, those who had breast cancer screening, cholesterol screening and cervical cancer screening were selected from databases compiled between 1980 and 2000. What was noted were that those who had cholesterol screening were more likely to receive changes in lifestyle counseling after their screening test when compared to those who had breast cancer screening and cervical cancer screening. Cholesterol screening testing was more likely to be prospective and to be done on those who were completely asymptomatic. Those who had breast cancer screening studies or cervical cancer screening studies were more likely to be retrospective studies.

All three screening types were associated with changes in behaviors, all of which were favorable. The biggest problem, however, was that follow up screening was not often done in the mistaken belief that one test was sufficient to provide risk factors. Data on cost effectiveness of both kinds of screening tests was not looked at in the study.

When it came to cholesterol screening, the test had a positive effect on heart-related behaviors. It was difficult to tell quantitatively what changes in behaviors existed and how much change actually happened but the general trend was toward the positive and follow up showed reduction in cholesterol level. On the other hand, few health studies have shown a change in behavior following breast cancer screening or cervical cancer screening.