Annual adult health screening: barriers, challenges and effectiveness

Abrar A. Al Yamani, Fahad A. Mahnshi, Abdullah A. Alkhalifah, Abdullah M. Alsawadi, Bader O. Alnefaie, Hussam S. Alzahrani, Mutasem S. Kutbi, Amro A. Bukhari, Turki M. AlQattan, Majid T. Tounsi, Rayan A. Alharbi


Although it has been well-established that screening for early detection and intervention practices has been associated with favorable outcomes, there have been many concerns about the potential of these approaches to cause harm to the patients. In addition, evidence also shows some associated barriers and challenges to these approaches that need to be considered by healthcare authorities when planning for such approaches. The present literature review discusses annual adult health screening programs' effectiveness, barriers, and challenges. There is no doubt that these screening programs can help identify undiagnosed disorders among many patients with various conditions, like diabetes mellitus, hypertension, and different cancers. Moreover, the effectiveness of these screening programs can be best highlighted by the premarital screening program in Saudi Arabia, which targets high-risk couples for developing certain conditions and infections. However, it should be noted that there are many barriers and challenges to conducting health screening campaigns, like cultural and economic factors. Other challenges might also include the rates of false-positive tests, overdiagnosis, and knowledge about the screening programs.


Screening, Healthcare, Prevention, Diagnosis, Early detection, Efficacy, Barriers

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Andermann A, Blancquaert I, Beauchamp S, Déry V. Revisiting Wilson and Jungner in the genomic age: a review of screening criteria over the past 40 years. Bull World Health Organ. 2008;86(4):317-9.

Moynihan R, Doust J, Henry D. Preventing overdiagnosis: how to stop harming the healthy. BMJ. 2012;344:e3502.

Welch HG, Schwartz L, Woloshin S. Overdiagnosed: making people sick in the pursuit of health. Beacon press. 2012.

Biller-Andorno N, Jüni P. Abolishing mammography screening programs? A view from the Swiss Medical Board. N Engl J Med. 2014;370(21):1965-7.

Rosenbaum L. Invisible risks, emotional choices--mammography and medical decision making. N Engl J Med. 2014;371(16):1549-52.

Metzger BE, Gabbe SG, Persson B. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33(3):676-82.

Bell N, Connor Gorber S, Shane A. Recommendations on screening for prostate cancer with the prostate-specific antigen test. Canad Med Assoc J. 2014;186(16):1225-34.

Alhamdan NA, Almazrou YY, Alswaidi FM, Choudhry AJ. Premarital screening for thalassemia and sickle cell disease in Saudi Arabia. Genetics in medicine. 2007;9(6):372-7.

Memish ZA, Saeedi MY. Six-year outcome of the national premarital screening and genetic counseling program for sickle cell disease and β-thalassemia in Saudi Arabia. Ann Saudi Med. 2011;31(3):229-35.

Alsaeed ES, Farhat GN, Assiri AM. Distribution of hemoglobinopathy disorders in Saudi Arabia based on data from the premarital screening and genetic counseling program, 2011-2015. J Epidemiol Glob Health. 2018;7(1):41-7.

Gosadi IM. National screening programs in Saudi Arabia: Overview, outcomes, and effectiveness. J Infect Public Health. 2019;12(5):608-14.

Alonazi WB. Exploring shared risks through public-private partnerships in public health programs: a mixed method. BMC Public Health. 2017;17(1):571.

Cheema S, Maisonneuve P, Lowenfels AB, Abraham A, Doraiswamy S, Mamtani R. Influence of Age on 2040 Cancer Burden in the Older Population of the Gulf Cooperation Council (GCC) Countries: Public Health Implications. Cancer Control. 2021;28:10732748211027158.

Thieu H, Bach Dat B, Nam NH. Antibiotic resistance of Helicobacter pylori infection in a children's hospital in Vietnam: prevalence and associated factors. Minerva Medica. 2020;111(5):498-501.

Alswaidi FM, O'Brien SJ. Is there a need to include HIV, HBV and HCV viruses in the Saudi premarital screening program on the basis of their prevalence and transmission risk factors? J Epidemiol Comm Health. 2010;64(11):989-97.

Abdullah SM. Prevalence of Hepatitis B and C virus infection and their co-relation with hematological and hepatic parameters in subjects undergoing Premarital Screening in the Jazan Region, Kingdom of Saudi Arabia. Pak J Med Sci. 2018;34(2):316-21.

Abulkhair OA, Al Tahan FM, Young SE, Musaad SM, Jazieh AR. The first national public breast cancer screening program in Saudi Arabia. Ann Saudi Med. 2010;30(5):350-7.

Dibas M, Doheim MF, Ghozy S, Ros MH, El-Helw GO, Reda A. Incidence and survival rates and trends of skull Base chondrosarcoma: A Population-Based study. Clin Neurol Neurosurg. 2020;198:106153.

Al Mulhim FA, Syed A, Bagatadah WA, Al Muhanna AF. Breast cancer screening programme: experience from Eastern province, Saudi Arabia. Eastern Mediterranean Health J. 2015;21(2):111-9.

Akhtar SS, Nadrah HM, Al-Habdan MA, et al. First organized screening mammography programme in Saudi Arabia: preliminary analysis of pilot round. Eastern Mediterranean Health J. 2010;16(10):1025-31.

El Bcheraoui C, Basulaiman M, Wilson S, Daoud F, Tuffaha M, AlMazroa MA, Memish ZA, Al Saeedi M, Mokdad AH. Breast cancer screening in Saudi Arabia: free but almost no takers. PLoS One. 2015 16;10(3):e0119051.

Son PT, Reda A, Viet DC, Quynh NXT, Hung DT, Tung TH, Huy NT. Exchange transfusion in the management of critical pertussis in young infants: a case series. Vox Sang. 2021;116(9):976-82.

Al-Daghri NM, Al-Attas OS, Alokail MS, Alkharfy KM, Yousef M, Sabico SL, Chrousos GP. Diabetes mellitus type 2 and other chronic non-communicable diseases in the central region, Saudi Arabia (Riyadh cohort 2): a decade of an epidemic. BMC Med. 2011;9:76.

Alyabsi M, Alhumaid A, Allah-Bakhsh H, Alkelya M, Aziz MA. Colorectal cancer in Saudi Arabia as the proof-of-principle model for implementing strategies of predictive, preventive, and personalized medicine in healthcare. EPMA J. 2020;11(1):119-31.

Mosli MH, Al-Ahwal MS. Colorectal cancer in the Kingdom of Saudi Arabia: need for screening. Asian Pacific J Cancer Prev. 2012;13(8):3809-13.

Alsanea N, Almadi MA, Abduljabbar AS, Alhomoud S, Alshaban TA, Alsuhaibani A, et al. National Guidelines for Colorectal Cancer Screening in Saudi Arabia with strength of recommendations and quality of evidence. Ann Saudi Med. 2015;35(3):189-95.

Khoja A, Aljawadi M, Al-Shammari SA, Bokhari NN, Aldarwish AA, Mardini WK, Khoja TA. Utilization of Colorectal Cancer Screening among Saudi Elderly Population: A Study from the Saudi National Survey for Elderly Health. Asian Pac J Cancer Prev. 2018;19(12):3401-7.

Hackl F, Halla M, Hummer M, Pruckner G. The Effectiveness of Health Screening. Health Economics. 2014;24.

El-Qushayri AE, Dahy A, Reda A, Mahmoud MA, Mageed SA, Kamel AMA, Ghozy S. A closer look at the high burden of psychiatric disorders among healthcare workers in Egypt during the COVID-19 pandemic. Epidemiol Health. 2021;43:e2021045.

McCaffery KJ, Jansen J, Scherer LD. Walking the tightrope: communicating overdiagnosis in modern healthcare. BMJ. 2016;352:348.

Welch HG, Black WC. Overdiagnosis in cancer. J Nat Cancer Institute. 2010;102(9):605-13.

Bell N, Connor Gorber S, Tonelli M. From ABCs to GRADE: Canadian Task Force on Preventive Health Care's new rating system for clinical practice guidelines. Canadian family physician Medecin de famille canadien. 2013;59(12):1282-9.

Carter JL, Coletti RJ, Harris RP. Quantifying and monitoring overdiagnosis in cancer screening: a systematic review of methods. BMJ. 2015;350:7773.

Barratt A. Overdiagnosis in mammography screening: a 45 year journey from shadowy idea to acknowledged reality. BMJ. 2015;350:867.

El-Qushayri AE, Ghozy S, Reda A, Kamel AMA, Abbas AS, Dmytriw AA. The impact of Parkinson's disease on manifestations and outcomes of Covid-19 patients: A systematic review and meta-analysis. Rev Med Virol. 2021;2278.

Bell NR, Grad R, Dickinson JA, Singh H, Moore AE, Kasperavicius D, Kretschmer KL. Better decision making in preventive health screening: Balancing benefits and harms. Can Fam Physician. 2017;63(7):521-4.

Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, Schünemann HJ; GRADE Working Group. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924-6.