Cost of mass CVD screening 'may not be justified'
By Lilian Anekwe
The Department of Health should abandon mass screening for cardiovascular disease and to switch a much cheaper and more cost-effective targeted strategy, researchers conclude.
Their study found selective screening identified more than 80% of high-risk individuals while requiring only 40% of the population to be screened.
Researchers analysed data from 3,921 asymptomatic members of the population aged 40-74, and conducted simulation models of five screening strategies - mass screening, screening in deprived areas, targeted screening of family members, and combinations of the latter two.
Using mass screening, 16 people would need to be screened to identify one individual at high risk of premature cardiovascular disease at a cost of £370.
Screening deprived communities targeted 17% of the population but identified 45% of those at high risk, and identified one high-risk patient for every 6.1 people screened at a cost of £141.
The proportion of the population included rose to 28% when family members were targeted, and identified 61%, or one for every 7.4 of those at high risk, at a cost of £170.
Combining approaches meant 84% of high risk individuals were identified by screening only 41% of the population.
By comparison, extending screening to the whole population identified only one additional high-risk person for every 58.8 screened at a cost of £1,358.
Study leader Professor Jill Pell, professor of public health and policy at the University of Glasgow, said: ‘In the absence of evidence it's been assumed mass screening must be better. But by targeting you can identify many more people.'
The study, published online by Heart, concluded: ‘The additional resources required for mass screening may not be justified.'Researchers found that a targeted strategy could be more cost-effective that mass screening for cardiovascular disease Researchers found that a targeted strategy could be more cost-effective that mass screening for cardiovascular disease