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.
Bibliographical noteFunding Information: This work was supported by the Wellcome Trust through a Senior Investigator Award to SS . The workshop on which the article is based, and the work of preparing the present manuscript, was supported by grants from the Wellcome Trust, the Canadian Institutes of Health Research [project grant Funding Reference Number PJT-148805, PI FAM], and the European Research Council [Starting Grant: CANCERSCREEN Screening for cancer in the post-genomic era: diagnostic innovation and biomedicalisation in comparative perspective, grant agreement No 716689, PI SH].The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
Open Access: This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publisher Copyright: © 2020 Sturdy S et al.
Citation: Sturdy S, Miller F, Hogarth S et al.Half a Century of Wilson & Jungner: Reflections on the Governance of Population Screening [version 2; peer review: 3 approved] Wellcome Open Research 2020, 5:158