Modern medical screening has a history of almost 100 years.1 During this time, a clear evolution of the ideas regarding screening has taken place although medical screening has evolved separately for distinct diseases and conditions. In order for screening to be beneficial, medical professionals need to know three things:
- Does earlier treatment improve prognosis?
- How valid and repeatable is the screening test?
- What is the yield of the screening service?
The effectiveness and cost-effectiveness of any screening service will be impacted by the answers to these questions as well as by the cost and predictive value of the test itself. Over time, screening for a specific disease has had varied priority based on the prevalence of that disease in society and the ability to effectively treat or prevent known disease. Medical imaging, genetic screening and the use of blood-based biomarkers to assess the likely presence of or heightened risk for particular diseases characterize today’s leading efforts in medical assessment.
Advances in biological and imaging technologies are rapidly improving the range of screening tools and applications available to detect disease earlier, improve outcomes and reduce costs. These innovative and emergent applications provide some of the most exciting opportunities for the advancement of medical screening. For example, cell state sequencing has major implications for the understanding and documentation of changes in disease state over time from pre-disease through disease development. Identifying disease producing genetic variants is an important tool in identifying predictive and preventive indicators of future disease in individual patients. Biomarker analysis in turn uses changes in key data indicators as predictive, preventative or personalized tools for disease states. As knowledge of biomarkers becomes more refined improvements in screening and pre-diagnosis are likely to emerge. Biotech advances are not alone in the progress within medical screening. Advances in imaging are also encouraging and hold promise for overcoming some of the limitations that have been found with earlier procedures.
The future of disease treatment lies partly in using advanced technologies to improve our ability to detect disease at its earliest stages when it is most treatable. The future of medical assessment includes transitioning from encounter-based assessment to continuous monitoring for the most prevalent, deadly and preventable of diseases.