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A health screening test is a medical test or procedure performed on members of an asymptomatic population or population subgroup to assess their likelihood of having a particular disease. Health professionals often think of screening for early diagnosis of cancer (such as Pap smears for cervical cancer or colonoscopy for colon cancer), but there are many other screening tests commonly used, for example, thyroid-stimulating hormone (TSH) for congenital hypothyroidism in newborns, cholesterol level for heart disease, urine drug screen for illicit drug use, or blood pressure for hypertension. Some screening tests are applied to a large segment of the population (for instance, all adults older than age 50), while others target a smaller subset of the population (pregnant women). Many screening tests are widely used in the United States. This activity provides guidelines on the current screening tests and the role of the interprofessional team in patient education on the benefits of screening. Objectives: Identify the function of screening tests. Describe the issues of concern with screening test. Explain the benefits of screening tests. Outline interprofessional team strategies for improving care coordination and communication to advance approved screening tests and improve outcomes. Access free multiple choice questions on this topic.

A health screening test is a medical test or procedure performed on members of an asymptomatic population or subgroup to assess their risk of developing a particular disease. We often think of screening for early diagnosis of cancer (such as Pap smears for cervical cancer or colonoscopy for colon cancer), but there are many other screening tests commonly used, for example, thyroid-stimulating hormone (TSH) for congenital hypothyroidism in newborns, cholesterol level for heart disease, urine drug screen for illicit drug use, or blood pressure for hypertension. Some screening tests are applied to a large segment of the population (eg, all adults older than 50), whereas others target a smaller subset (eg, pregnant women). Many screening tests are widely used in the United States. Healthcare providers can agree that early diagnosis of a life-threatening disease for which effective treatment is available is a positive step. Unfortunately, health screening is complicated. Many articles on screening present a bewildering array of medical economics and biostatistics to make their points, and numerous credible organizations have offered their own (often differing) screening recommendations. The economic implications of screening are real. Even a single screening test applied to a large number (millions) of people can result in billions of dollars in annual health care expenditure. There are legitimate debates about sensitivity and specificity, disease prevalence, predictive values, lead-time bias, screening intervals, and appropriate cutoffs for positive or negative results. Recently, "shared decision making" has been suggested as an option when there is uncertainty about the advisability of a particular screening test (such as the prostate-specific antigen, or PSA, for the early diagnosis of prostate cancer). That may be possible if your patient is an educated professional. However, asking a patient without medical training to understand issues that challenge the intellect and judgment of most trained clinicians does not seem realistic. That the issue arises underscores the urgent need for improved screening tests.[1][2][3][4][5][6]

Healthcare workers should not order screening tests for which there is insufficient evidence or that are very rare. This only leads to higher healthcare costs and subjects patients to unnecessary tests and procedures. It is important to discuss the merits of a screening test with the healthcare team before ordering it. Both the U.S. Preventive Services Task Force (USPSTF) and the American Academy of Family Physicians (AAFP) offer broad screening recommendations that consider, in detail, the pros and cons of various screening tests. If there is a doubt about a screening test, consultation from a specialist should be sought. Only through open communication among clinicians can screening tests be used appropriately and reduce healthcare costs.

Nurse practitioners should be familiar with disorders that can be screened for. In general, screening for rare disorders is a waste of time and is associated with higher healthcare costs. It is important to consult with a specialist before ordering a screening test. Most screening tests have not met expectations.