Public need better information about screening, say MPs

In collaboration with the Press Association

People are not always provided with sufficient information about the risks of screening for chronic diseases such as cancer, according to an influential group of MPs.

"The report highlights the importance of ensuring people get the best possible information, so they can make the decisions that are right for them" - Jess Kirby, Cancer Research UK

Screening healthy people can detect disease earlier and allow for more effective treatment. But it can also have down sides, such as inaccurate results and unnecessary treatment, the Science and Technology committee found.

Around 11 million people in England are invited for some form of screening every year, with breast, cervical and bowel cancer programmes costing around £348 million - while a further £400 million is spent on non-cancer screening.

But the committee found that while there are clear benefits to screening, public perception is so positive that it is difficult to convey the downsides.

In light of a review of evidence, reforms have recently been made to NHS breast cancer screening information to help patients make an "informed choice" about whether the test is right for them.

But the committee noted that this approach wasn’t yet extended across all screening programmes.

MPs called on the UK National Screening Committee (UK NSC), the government advisory group, to draw up general screening guidelines to ensure patients are given all the facts.

Committee chairman Andrew Miller said: "Like any medical intervention, screening carries both benefits and risks, whether that is for breast cancer, for aneurysms or hypothyroidism in newborns.

"However, health screening is seen in such a positive light by the public that it can be challenging to convey the negative side of the equation.

"While screening can increase the likelihood of curing, preventing or delaying the progression of disease for some patients, for others it may lead to false results, misdiagnosis and unnecessary treatment.

"More needs to be done to ensure that both the benefits and risks are clearly, and even-handedly, communicated so that people can make an informed choice about whether screening is right for them."

Jessica Kirby, Cancer Research UK’s senior health information manager – who gave evidence to the committee – said the report’s findings were “great to see”.

“It’s vitally important that all screening programmes are based on the best possible evidence, so people can be confident that screening is only offered where the benefits outweigh the harms.

“Overall the report highlights the importance of ensuring people get the best possible information so they can make the decisions that are right for them,” she added.

The committee also raised concerns over the NHS Health Check programme introduced in 2009 that offers patients a so-called ‘MOT’ from the age of 40.

The programme - which is aimed at preventing heart disease, stroke, diabetes and kidney disease - was introduced five years ago and was not reviewed by the UK NSC because it is not classed as a screening programme, the committee found.

This lack of scrutiny gives rise to "serious questions" about quality of the evidence over whether it can achieve its aims, leaving MPs concerned it could be "wasting resources".

The MPs also concluded that more needed to be done to future-proof the NHS screening programmes in the light of advances in understanding how people’s genes affect their risk of disease.

Mr Miller added: "Developments in genetic science mean that it should soon become possible to target screening programmes directly at those most of risk of certain diseases.

"It is imperative that the UK National Screening Committee develops its capacity for horizon scanning and ensures that proven developments in screening are supported and implemented across the NHS."