Disease Screening in Public Health

Current and future public health is characterized by the increase of chronic and degenerative diseases, corresponding to the worldwide ageing of the population. The increasing prevalence of these conditions together with the long incubation period of the chronic diseases and the continual technological innovations, offer new opportunities to develop strategies for early diagnosis. Public Health has an important mandate to critically assess the promises and the pitfalls of disease screening strategies. This MOOC will help you understand important concepts for screening programs that will be explored through a series of examples that are the most relevant to public health today. We will conclude with expert interviews that explore future topics that will be important for screening. By the end of this MOOC, students should have the competency needed to be involved in the scientific field of screening, and understand the public health perspective in screening programs. This MOOC has been designed by the University of Geneva and the University of Lausanne. This MOOC has been prepared under the auspices of the Ecole romande de santé publique (www.ersp.ch) by Prof. Fred Paccaud, MD, MSc, Head of the Institute of Social and Preventive Medicine in Lausanne (www.iumsp.ch), in collaboration with Professor Antoine Flahault, MD, PhD, head of the Institute of Global Health, Geneva (https://www.unige.ch/medecine/isg/en/) and Prof. Gillian Bartlett-Esquilant (McGill University, Quebec/ Institute of Social and Preventive Medicine, Lausanne).

• Introduction to Key Concepts in Screening
• This module will provide a brief welcome by Dr. Fred Paccaud and Dr. Antoine Flahault. An overview of screening and an introduction on how the course is organized and evaluated will be provided by Dr. Gillian Bartlett-Esquilant. Dr. Idris Guessous, a Senior Lecturer in the Population Epidemiology Unit in the Department of Community Medicine, Primary Care and Emergency Medicine (Geneva), and in the Department of Ambulatory Care and Community Medicine (PMU Lausanne) & Division of Chronic Diseases at the Institute of Social and Preventive Medicine (Lausanne) will provide lectures on definitions of screening. Natural history of diseases and the characteristics of subclinical conditions allowing early diagnosis will be presented. A quiz on the key concepts for screening will complete this module.
• Screening Metrics
• The second module, provided by Dr. Idris Guessous, will address the metrics of screening with concepts related to robustness, validity and impact. A quiz on screening metrics will complete this module.
• Screening in Pregnancy and Newborns
• This module on screening in the prenatal (pregnancy) and perinatal (newborn) stage of life is given by Professor Murielle Bochud, MD, PhD, head of the Institute of social and preventive medicine in Lausanne, Switzerland. A quiz will complete this module.
• Screening for Cardiometabolic Conditions
• Senior lecturer Arnaud Chiolero, MD, PhD, from the Division of Chronic Diseases at the Institute of Social and Preventive Medicine in Lausanne will be presenting three case studies related to the increasingly prevalent condition of cardiometabolic disease. Three different diseases will be explored in terms of burden of disease, benefits and harms, evidence and issues followed by recommendations about whether screening should be implemented. A quiz will complete this module.
• Cancer Screening
• Cancer is a classical field for screening because of both the improvement of the prognosis for most cancers and the usually long incubation period. This part of the MOOC will present current data, evidence and policies regarding the most important cancer sites that include colorectum, prostate, lung, cervix, breast and skin. This module is given by several experts including Elisabetta Rapiti from the Geneva Cancer Registry at the Institute of Global Health in Geneva; Professor Antoine Flahault, who is the Head of the Institute of Global Health in Geneva; and Jean-Luc Buillard who is a Senior Lecturer in the Division of Chronic Diseases at the Institute for Social and Preventive Medicine in Lausanne. A quiz will complete this module.
• Public Mental Health and Screening in Ageing
• This module explores the topics of public mental health and screening in the ageing population for neuropsychiatric conditions and physical impairments such as hearing loss. This module is given by several experts including Emiliano Albanese, assistant professor in public mental health in the Department of Psychiatry at the University of Geneva and the Director of the WHO Collaborating Center for Research and Training in mental health at the University of Geneva; Professor Christophe Bula who is the head of the geriatric and geriatric rehabilitation service at the Vaudois University Hospital Centre; Professor Armin von Gunten who is the head of the university service for geriatric psychiatry at the Vaudois University Hospital Service. A quiz will complete this module.
• Screening in Low and Middle-Income Countries and Migrants
• The globalization of non-communicable diseases is a major challenge in low and middle income countries (LMIC). At the same time, migration is occurring between these countries and high income countries. Screening for cardiovascular diseases and for cancer in low and middle income countries will be presented and discussed. In addition, the special consideration of screening of migrants from these countries will be addressed. This module is given by: Professor Pascal Bovet from the Division of Chronic Diseases at the Institute of Social and Preventive Medicine in Lausanne; Dr. Catherine Sauvaget from the International Agency for Research on Cancer (IARC) in Lyon, France; and Professor Patrick Bodenmann from the Polimedical University Clinic and head of the Centre for Vulnerable Populations. A quiz will complete this module.
• Evaluation, Planning, Implementation and the Future of Screening Programs
• In this final module, important aspects of for the evaluation, planning and decision making about the implementation or stopping of screening programs will be presented. This material is given by Senior lecturer Jean-Luc Bulliard who is an epidemiologist in the Division of Chronic Diseases at the Institute for Social and Preventive Medicine in Lausanne. The conclusion of the module will be a series of interviews with experts on the future of disease screening in public health conducted by Dr. Gillian Bartlett-Esquilant, a visiting professor at the Institute for Social and Preventive Medicine at Lausanne. A quiz will close this module.