Therefore, the diagnostic accuracy depends on both time taken to read the images and experience of the screening practitioner.
Subjects testing positive are informed by post and invited to meet a specialist screening practitioner (most often a nurse) at one of 58 screening centres.
Participants with five or six positive windows (a strong positive or 'abnormal' result) are offered an appointment with a specialist screening practitioner (SSP) to discuss further investigation, usually colonoscopy.
Participants who return a test kit with five or six positive windows (a 'strong positive' and thus a definitive 'abnormal' result) are offered a consultation with a Specialist Screening Practitioner (SSP) to discuss a follow-up examination (usually colonoscopy).
Kits are dispatched by, and returned to, one of five testing laboratories (referred to as hubs), each one covering a large region of England as shown in figure 1. Subjects returning kits in which five or six windows test positive are deemed abnormal and are immediately referred to a nurse-run clinic (specialist screening practitioner (SSP) clinic) at their local screening centre (figure 2).
Health insurance plans are expected to screen unqualified practitioners from the network, provide a moderate level of utilization review and oversight to avert abuses and fraud, and establish modest incentives to encourage clinical improvement.
To date, no long-term controlled trials have been performed to evaluate anal cancer screening; hence, practitioners often rely on the approaches used for cervical cancer screening 25.
Sitting in front of the screens, the practitioners can visually detect and assess the condition of the assets based on their own experience and a condition assessment handbook.
We also consulted an expert panel comprising experts in bowel cancer screening, general practitioners, experts in adult literacy, and linguists.
Before implementing the SAPAS-AV as part of a routine screening programme, practitioners needs to give due and balanced consideration to potential useful as well as harmful consequences to the young people being screened.
