ABSTRACT
Screening in adults is potentially big business. Private screening organisations offer a variety of screening tests for a range of conditions, including osteoporosis, Helicobacter pylori and prostate cancer, from mobile units around the country, often parked in supermarket car parks. As Laurence has pointed out in relation to screening for both breast and cervical cancer, 'Medicine is not an exact science'. Screening for prostate cancer is the subject of continuing controversy. The main diagnostic test is the prostate-specific antigen test, and digital rectal examination and transrectal ultrasound can also be used, with confirmation by biopsy. Cardiovascular and related diseases have taken over from the infectious diseases of the nineteenth century as the main causes of death in the industrialised world. Coronary heart disease is the leading single cause of death in the UK. Screening for risk factors for coronary heart disease and stroke should be performed in the primary care setting, with advice, treatment and follow-up being given as appropriate.
