Why is selective screening bad?

• A. It reduces staff workload.
• B. It ensures resources are prioritized.
• C. It improves accuracy.
• D. It leads to missed needs and bias in care.

Answer: (D)

Selective screening focuses only on people who meet certain risk criteria, but risk factors are not perfect predictors. Many individuals who have the condition may not fit the criteria and won’t be screened, while others flagged as at risk may never develop it. That means cases go undetected, leading to delays in diagnosis and treatment and worse outcomes for patients who were missed. It also introduces bias—by concentrating screening on specific groups, other groups’ needs may be overlooked, widening disparities in care and eroding trust. So, even if selective screening seems efficient, the real cost is missed needs and biased care.

Choosing options that suggest workload reduction or resource prioritization overlooks the patient-impact issue, and the idea that it improves accuracy isn’t accurate in practice, since overall detection is often reduced.