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Leading expert calls for new rules on medical screening

Leading epidemiologist and preventive health expert, Professor Nicholas Wald has called for a new Medical Screening Code of Practice to protect the public against insurance companies who ardently promote health screening services which have no evidence of even benefiting customers.



Writing in the Journal of Medical Screening, which he edits, Professor Wald said:



"There is, emerging in Britain, a culture in which judgments on medical screening practice are being made in the absence of evidence. The culture needs to change, so that screening is subject to professional scientific assessment."



He said that screening is a weak means of providing reassurance because it misses out most cases of the disease for which it is carried out. He believes that screening tests can even damage customers’ health.



"Not only do we lack evidence that this sort of screening confers a benefit, we do know that it will also cause harm,” Professor Wald wrote.



“This is not just from the radiation risk of some imaging techniques - other techniques can carry a risk of physical harm. Also anxiety over the risk of false positives and the false reassurance of false negatives is a concern.



"In medical screening there is always some harm, which is only acceptable if there are also confirmed benefits that outweigh the harm."



As of yet, there are very little trials that have proven either computerised tomography (CT) scanning of the heart, nor virtual (CT) colonoscopy are of benefit, and the X-ray radiation exposure involved in both procedures is a concern, Professor Wald warns.



It was widely believed that screening is useful to detect osetoporosic fractures and certain types of heart disease, but the health expert argues that it is a poor discriminator of who will develop these disorders and that its detection of diabetes is also uncertain.



Professor Wald believes that if government regulation is to be avoided, health service providers, insurers and scientists need to work together to produce a Medical Screening Code of Practice. Such a code would help to reassure the public and better enable them to judge the value and benefit of screening services.

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