AN ECONOMIC-VIEW OF HIGH COMPLIANCE AS A SCREENING OBJECTIVE

Accepted wisdom holds that high compliance is essential for a screenin g programme to be successful. Indeed, a reason that the national breas t screening programme is not routinely offered to women aged 65 or mor e is on the grounds of predicted poor compliance by older women. Incre asing compliance is often associated with increased costs. These costs represent a lost opportunity for screening alternative target populat ions. We question the need for screening programmes to achieve high co mpliance, and we argue that a screening programme can be efficient wit h very low levels of compliance. Adopting compliance as a screening ob jective and as a measure of the success of screening may be detrimenta l to the efficiency of a screening programme.