Solid reasons to equitably screen

Nav Persaud, Aisha Lofters

Abstract


Preventive care can address inequities, or avoidable disparities in health outcomes. Preventive care, including screening for cardiovascular disease and cancer, and health promotion including offering counselling and preventive treatments, remains a routine part of primary care for good reasons. Here, we provide a fresh perspective on preventive care that focuses on health equity and we explain how centering on health equity can bring into focus the demonstrated benefits of screening in the context of other primary care interventions, the importance of patient preferences, and the relative magnitude of screening harms. Informed patients often prefer screening, and this should be offered where reasonable and the potential implications of negative screening recommendations for health equity should be carefully considered. The evidence for screening is better than the evidence of many other routine and uncontroversial aspects of care and the downsides of screening are sometimes overstated.


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