NURS 8310 Week 8 Screening for Diseases Essay Assignment

What might happen to cancer rates if existing screening tests were no longer used? Consider, as an example, colorectal cancer. The American Cancer Society (ACS) identifies colorectal cancer as the third most common cancer in men and women, as well as the second leading cause of cancer-related death (2011). Colorectal cancer screening tests can detect abnormal cell growth before cancer even forms, allowing for early detection, more successful treatment, and—in some cases—the prevention of cancer altogether. The ACS recommends this screening for all men and women over the age of 50 and earlier for individuals with additional risk factors. Much to the credit of screening procedures, “the death rate from colorectal cancer has been dropping for more than 20 years” (ACS, 2011).

Scientists are continually seeking to develop new screening tests that can detect diseases earlier. Screening is an essential tool for the secondary prevention of disease. It is used when the earlier detection of disease is associated with an improved outcome, as is the case with colorectal cancer. This week, you will examine the process of screening for disease, the effectiveness of different screening tests, and the controversies that surround screening programs.

Learning Objectives

Students will:

Analyze how epidemiologic data are used to argue for or against a screening program
Analyze how epidemiologic data can be used to formulate policy for improving population health
Evaluate the social impact of addressing a population health problem
Develop an evaluation plan for a health intervention

Discussion: Screening for Disease

Although many individuals and organizations may endorse the goal of screening programs, the details and implementation are often controversial. For some types of screening, it can be quite challenging to weigh the human and economic costs and benefits and determine a clear recommendation. For instance, in an article in the New England Journal of Medicine, Dr. Michael Barry (2009) indicates that “serial PSA [prostate-specific–antigen] screening has at best a modest effect on prostate-cancer mortality during the first decade of follow-up. This benefit comes at the cost of substantial over-diagnosis and overtreatment. It is important to remember that the key question is not whether PSA screening is effective but whether it does more good than harm.”

This week’s Learning Resources include articles about screening programs for four different diseases that contain potentially controversial recommendations. For this Discussion, you will select a disease and examine the epidemiological evidence to assess a recommendation for screening guidelines. In addition, you will consider possibilities for furthering policy to promote population health related to this disease.

To prepare:

Review the four articles concerned with screening and public policy listed in this week’s Learning Resources. All four articles contain potentially controversial recommendations for screening and prevention.
Select one article on which to focus for this Discussion.
Analyze how the epidemiologic data could be used to formulate policy for improving population health.

By Day 3

Post a cohesive scholarly response that addresses the following:

Summarize the recommendations of your selected article. Discuss ethical considerations and whether or not you believe the recommendations are justified.
Describe the epidemiological evidence in support of your position.
Identify whether the screening program you review is population-based or high-risk based and how that influences your assessment.
How can the reported data be used to move policy forward for improving population health around this issue?

By Day 6

Respond to the postings of at least two colleagues who commented on an article you did not select. Review his or her summary and make an argument to support a different position. Again, cite epidemiological evidence that supports your opposing view.

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