Screening tests of unproven benefit
The following are not recommended as screening tests in low risk general practice populations. These tests may have value as diagnostic tests or as tests to monitor disease progression.
| Screening test | Condition | Reason not to use | References for further reading |
|---|---|---|---|
| Abdominal ultrasound | Abdominal aortic aneurysm | No evidence of improved outcome | 466 |
| Bimanual vaginal examination |
|
There is no evidence to support. Pelvic examinations may be performed at the time of routine Pap tests to aid in technical issues with the Pap test itself | 467 |
| Bone mineral density | Osteoporosis | Low specificity. Low predictive value for fracture in low risk populations | 468 |
CA125 |
Ovarian cancer | Less than 50% of women presenting with FIGO stage I ovarian cancer have elevated levels of CA125 |
469 |
| Transabdominal or transvaginal ultrasound | No evidence to recommend routine screening for women in general | ||
| Chest X-ray | Lung cancer | There is no evidence that screening for lung cancer with chest X-ray decreases mortality from lung cancer | 470 |
| Coronary calcium CT scanning (electron-beam computerised tomography [EBCT] scanning for coronary calcium) | Coronary heart disease | There is fair evidence that these are ineffective and that the harms outweigh the benefits | 471 |
| Exercise electrocardiograph (ECG) | Coronary artery disease | Low sensitivity and specificity | 472 |
| Helical computerised tomography | Lung cancer | Lack of evidence of benefit. However, a trial is currently underway with smokers | 473 |
| Magnetic resonance angiography or digital subtraction angiography | Cerebrovascular abnormalities | Low prevalence, lack of sensitivity and evidence of improved outcome | 474 |
| Prostate specific antigen (PSA) test | Prostate cancer | Lack of sensitivity, specificity and evidence of improved outcome | 479 |
| Respiratory function tests | Chronic obstructive pulmonary disease (COPD) | Screening a practice population is possible but difficult. Insufficient evidence of improved outcomes | 476 |
| Screening for asymptomatic bacteuria in elderly | Urinary tract infection | No evidence to support benefit | 477 |
| Thyroid function tests | Hyper- or hypo-thyroidism | Screening for congenital hypothyroidism in neonates is recommended. However, it is not recommended in adults, even if family history because of low prevalence and lack of evidence of benefit | 478 |
| Whole body CT scanning | Various cancers | There is no evidence of benefit. There is evidence of harm due to increased radiation exposure | 479 |
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