Table 2 Criteria used by the UK National Screening Committee for the appraisal of a new formal screening program and verdict applied to alcohol misuse

1. The condition should be an important health problem

2. The epidemiology and natural history of the condition, including development from latent to declared disease, should be adequately understood, and there should be a detectable risk factor, disease marker, latent period, or early symptomatic stage

3. If the carriers of a mutation are identified as a result of screening, the natural history of people with this status should be understood, including the psychological implications

4. All the cost-effective primary prevention interventions should have been implemented as far as practicable

5. There should be a simple, safe, precise, and validated screening test

6. The distribution of the test values in the target population should be known and a suitable cut-off level defined and agreed

7. The test should be acceptable to the population

8. There should be an agreed policy on the further diagnostic investigation of individuals with a positive test result and on the choices available to those individuals

9. If the test is for mutations, the criteria used to select the subset of mutations to be covered by screening, if all possible mutations are not being tested, should be clearly set out

10. There should be an effective treatment or intervention for patients identified through early detection, with evidence of early treatment leading to better outcomes than late treatment

11. There should be agreed evidence-based policies covering which individuals should be offered treatment and the appropriate treatment to be offered

12. Clinical management of the condition prior to participation in a screening program and patient outcomes should be optimized in all health care providers

13. There should be evidence from high-quality randomized controlled trials that the screening program is effective at reducing mortality or morbidity