The costs of prevention

BMJ 1995;311:1520 (9 December)

Editorials

The costs of prevention

Not necessarily better than cure

To many doctors it seems fundamentally wrong to let people becomeill before intervening when it would be possible to take effectiveaction at an earlier stage--for example, by screening. Delayedintervention results in avoidable suffering and possibly a muchpoorer prognosis. People are also willing to believe that screeningis a good investment, whereby costs are incurred now to avoidgreater costs in the future. This faith in early action is partof folk wisdom, captured in aphorisms such as "a stitch in timesaves nine." In short, there is a widely held view that preventionis better than cure.

If women aged 65-69 are not routinely screened for breast cancer,or are screened every three years rather than every two years,some will not receive care that would benefit them. However,the view that it is wrong not to benefit a particular group. . . [Full text of this article]

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