The Benefits and Harms

The classic Wilson and Jungner criteria (from 1962) outline ten principles to evaluate whether screening for a disease should be conducted. There have been other updates to this criteria in recent years, notably by Anne Andermann from a genetic screening perspective and by Harris et al from the US Preventive Services Task Force working on chronic disease screening and prevention. In summary, these criteria appraise the ethical, epidemiological, diagnostic, prognostic, economic and clinical features of a disease, its outcomes and the population defined as ‘at risk’. At the heart is a desire to weigh the intended benefits (prevention of disease progression through identification and treatment of pre-clinical or risk groups) against the incidental harms (the negative implications of intervention among otherwise healthy populations).