Screening: Evidence and practice - Tapa blanda

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Sir Muir Gray has been the driving force behind the transformation of screening in the UK. In the 1980s he secured £25,000 from the Department of Health to resolve the problematic cervical screening programme by harnessing the experience and commitment of pathologists, public health physicians, and gynaecologists throughout the service he transformed it into the quality assured public health programme it is today. Muir also masterminded the implementation of a nationwide breast screening programme. He then turned his attention to wider screening, setting up the National Screening Programmes which brought evidence, order and effectiveness to a disparate set of public health risk reduction programmes. Muir has also established the National Library for Health, been instrumental in helping establish the Cochrane Collaboration, and has brought accessible evidence-based information to the fingertips and desktops of all clinicians by publications such as Clinical Evidence. Dr Angela Raffle became involved in screening in 1985 when she took on responsibility for the cervical screening programme in and around Bristol and Bath. Working with Dr Elisabeth Mackenzie, she analysed the screening records for the 250,000 women in the programme. The results were worrying, demonstrating the scale of overdetection and overtreatment inherent in cervical screening. She articulated her findings, not as a polemicist from outside the programme, but as a professional involved in screening, committed to serving the women who participated. Angela became part of the National Coordinating Network, has worked on a wide range of screening policy issues for the National Screening Programmes, and has continued her commitment to teaching nationally and internationally. In Bristol she is responsible for all aspects of cancer services including the cancer screening programmes. She has also been a major player in the Smoke-free Bristol campaign and palliative care services at the end of life.