The Wilson-Jungner criteria for a good screening programme include all of the following EXCEPT:

• A The natural history of the condition should be adequately understood
• B The screening test should be a gold-standard confirmatory diagnostic test ✓
• C There should be an agreed policy on whom to treat as patients once screening is positive
• D The cost of screening should be economically balanced by expenditure on medical care as a whole

Explanation

Wilson and Jungner's 10 criteria for a valid screening programme (1968) specify that the screening test should be 'simple, safe, precise and validated,' NOT that it be the gold-standard diagnostic test. Screening tests are intentionally chosen to be sensitive and easy to apply; they are followed by a separate confirmatory diagnostic test when positive. The other listed criteria are genuine Wilson-Jungner requirements: understanding natural history, having agreed treatment policy, and economic balance. A screening test that is the gold standard would be too expensive and invasive to apply to populations.

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

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