Skriinimises

Skriinimises is the Estonian term for the process of screening in healthcare. It refers to the systematic assessment of individuals who do not have symptoms, with the aim of identifying those at increased risk for a disease or condition, so that preventive measures or early treatment can be offered. Screening differs from diagnostic testing, which is used when symptoms or signs are present. In public health, skriinimises can be applied to whole populations or to specific groups considered at higher risk, and its design may be population-based or targeted.

A typical screening program includes defined criteria for participation, informed consent, testing using a chosen method, interpretation of results, and follow-up with diagnostic confirmation or intervention. Key performance characteristics include sensitivity, specificity, and predictive values, and programs are often evaluated for effectiveness, cost-effectiveness, and equity. Ethical and legal considerations include informed consent, privacy, potential harms such as false positives, anxiety, overtreatment, and stigmatization.

Examples of skriinimises in practice include cancer screening (for example, mammography for breast cancer, Pap tests or HPV testing for cervical cancer, and screening colonoscopy or stool-based tests for colorectal cancer), newborn screening for metabolic or hormonal disorders, and infectious disease screening (such as HIV or hepatitis B/C testing in certain settings). The design of a screening program often follows established criteria, such as those proposed by Wilson and Jungner, and is adapted over time based on new evidence about benefits and harms.

Limitations include the risk of overdiagnosis, lead-time bias, and unequal access. When implemented thoughtfully, skriinimises can contribute to early detection and improved health outcomes, while reducing disease burden at the population level.