TY - JOUR
T1 - Half a Century of Wilson & Jungner
T2 - Reflections on the Governance of Population Screening
AU - Sturdy, Steve
AU - Miller, Fiona
AU - Hogarth, Stuart
AU - Armstrong, Natalie
AU - Chakraborty, Pranesh
AU - Cressman, Celine
AU - Dobrow, Mark
AU - Flitcroft, Kathy
AU - Grossman, David
AU - Harris, Russell
AU - Hoebee, Barbara
AU - Holloway, Kelly
AU - Kinsinger, Linda
AU - Krag, Marlene
AU - Löblová, Olga
AU - Löwy, Ilana
AU - Mackie, Anne
AU - Marshall, John
AU - O'Hallahan, Jane
AU - Rabeneck, Linda
AU - Raffle, Angela
AU - Reid, Lynette
AU - Shortland, Graham
AU - Steele, Robert
AU - Tarini, Beth
AU - Taylor-Phillips, Sian
AU - Towler, Bernie
AU - van der Veen, Nynke
AU - Zappa, Marco
N1 - Copyright: © 2020 Sturdy S et al.
PY - 2020/7/6
Y1 - 2020/7/6
N2 - Background: In their landmark report on the "Principles and Practice of Screening for Disease" (1968), Wilson and Jungner noted that the practice of screening is just as important for securing beneficial outcomes and avoiding harms as the formulation of principles. Many jurisdictions have since established various kinds of "screening governance organizations" to provide oversight of screening practice. Yet to date there has been relatively little reflection on the nature and organization of screening governance itself, or on how different governance arrangements affect the way screening is implemented and perceived and the balance of benefits and harms it delivers.Methods: An international expert policy workshop convened by Sturdy, Miller and Hogarth.Results: While effective governance is essential to promote beneficial screening practices and avoid attendant harms, screening governance organizations face enduring challenges. These challenges are social and ethical as much as technical. Evidence-based adjudication of the benefits and harms of population screening must take account of factors that inform the production and interpretation of evidence, including the divergent professional, financial and personal commitments of stakeholders. Similarly, when planning and overseeing organized screening programs, screening governance organizations must persuade or compel multiple stakeholders to work together to a common end. Screening governance organizations in different jurisdictions vary widely in how they are constituted, how they relate to other interested organizations and actors, and what powers and authority they wield. Yet we know little about how these differences affect the way screening is implemented, and with what consequences.Conclusions: Systematic research into how screening governance is organized in different jurisdictions would facilitate policy learning to address enduring challenges. Even without such research, informal exchange and sharing of experiences between screening governance organizations can deliver invaluable insights into the social as well as the technical aspects of governance.
AB - Background: In their landmark report on the "Principles and Practice of Screening for Disease" (1968), Wilson and Jungner noted that the practice of screening is just as important for securing beneficial outcomes and avoiding harms as the formulation of principles. Many jurisdictions have since established various kinds of "screening governance organizations" to provide oversight of screening practice. Yet to date there has been relatively little reflection on the nature and organization of screening governance itself, or on how different governance arrangements affect the way screening is implemented and perceived and the balance of benefits and harms it delivers.Methods: An international expert policy workshop convened by Sturdy, Miller and Hogarth.Results: While effective governance is essential to promote beneficial screening practices and avoid attendant harms, screening governance organizations face enduring challenges. These challenges are social and ethical as much as technical. Evidence-based adjudication of the benefits and harms of population screening must take account of factors that inform the production and interpretation of evidence, including the divergent professional, financial and personal commitments of stakeholders. Similarly, when planning and overseeing organized screening programs, screening governance organizations must persuade or compel multiple stakeholders to work together to a common end. Screening governance organizations in different jurisdictions vary widely in how they are constituted, how they relate to other interested organizations and actors, and what powers and authority they wield. Yet we know little about how these differences affect the way screening is implemented, and with what consequences.Conclusions: Systematic research into how screening governance is organized in different jurisdictions would facilitate policy learning to address enduring challenges. Even without such research, informal exchange and sharing of experiences between screening governance organizations can deliver invaluable insights into the social as well as the technical aspects of governance.
KW - Governance
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=85091363539&partnerID=8YFLogxK
U2 - 10.12688/wellcomeopenres.16057.2
DO - 10.12688/wellcomeopenres.16057.2
M3 - Article
C2 - 32923689
SN - 2398-502X
VL - 5
JO - Wellcome Open Research
JF - Wellcome Open Research
M1 - 158
ER -