Editorials

The costs of prevention

BMJ 1995; 311 doi: http://dx.doi.org/10.1136/bmj.311.7019.1520 (Published 09 December 1995) Cite this as: BMJ 1995;311:1520
  1. John Cairns
  1. Director Health Economics Research Unit, Aberdeen AB9 2ZD

    Not necessarily better than cure

    To many doctors it seems fundamentally wrong to let people become ill before intervening when it would be possible to take effective action at an earlier stage—for example, by screening. Delayed intervention results in avoidable suffering and possibly a much poorer prognosis. People are also willing to believe that screening is a good investment, whereby costs are incurred now to avoid greater costs in the future. This faith in early action is part of folk wisdom, captured in aphorisms such as “a stitch in time saves nine.” In short, there is a widely held view that prevention is 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 …

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