Wilson and Jungner (1968) criteria for a valid screening programme include which of the following statements as the MOST fundamental prerequisite?

• A A suitable screening test must be available with high sensitivity and specificity
• B The cost of case finding must be economically balanced in relation to medical expenditure as a whole
• C There must be an agreed policy on whom to treat as patients
• D The condition sought should be an important health problem with an identifiable latent or early symptomatic stage ✓

Explanation

The first and most fundamental Wilson-Jungner criterion is that the condition must be an important public health problem (significant morbidity/mortality burden) AND must have a recognisable latent or early symptomatic stage — because screening is only rational if the disease has a detectable preclinical phase where intervention is possible. All other criteria (test availability, treatment availability, cost-effectiveness, agreed treatment policy) follow from and depend upon this foundation. Without a detectable preclinical phase, no screening programme can be justified regardless of test quality or cost.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

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