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Some of us are still around thanks to adequate health screening. People are encouraged in various ways to undergo screening tests, mainly to identify possible health conditions. In fact, early detection in order to improve the outcome of treatment and possibly survival is the cornerstone of several health conditions such as diabetes, coronary heart disease, breast and cervical cancer.

However, health screening threatens to change our psychological identity. In other words, the possibility of a diagnosis of a serious disease such as cancer looms on the sense of who we are and on our sense of security in the world. This creates anxiety, distress and fear which are often fundamental barriers to health screening.

By the same token, some people choose to preserve their healthy identity through overrating their immunity and endorsing the illusion of invulnerability. They do not see themselves as susceptible to disease and falsely believe that they will never get sick.

The list of reasons as to why some follow rigorous screening procedures while others opt out of health screening is endless. Knowledge about the screening process and the disease itself is a crucial factor which determines healthy behaviour. Unclear information fuels misconceptions and procrastination – people might falsely believe that a test is more painful and complicated than it actually is and they will delay or refuse to take the test.

The possibility of a diagnosis of a serious disease such as cancer looms on the sense of who we are and on our sense of security in the world

Similarly, if people are well aware of the seriousness of a disease and of the benefits of early detection, they are more likely to seek screening or attend population based health checks.

Perceived ability to deal with bad news is another significant component – it’s as if people who believe that they cannot cope with bad news are more likely to hold back.

The process of health screening is not without controversy and while one appreciates the value of screening, there are also inherent risks. One of the risks is that screening can provide feedback which is not accurate or else might be false. An example is when people are given a false positive and told that a condition is present when it is not, or when a result is abnormal without diagnosis of disease. This is a cause for concern as such results are stressful and often instil a misperception of someone’s health situation.

Preparing for such a situation is crucial and delicate. Communication to minimise the potential harm of screening while maximising its effects is recommended. People benefit if they are supported in finding a balance between being fully aware of these risks, while at the same time acknowledging the seriousness of the situation. When ade­­-quately informed, individuals can better decide whether they want to carry the risks of the screening test or risks the consequences of losing their chance of early diagnosis of a disease, which in the case of the latter, often spells an earlier death.

Another risk is when screening gives a false sense of security. This refers to those cases where a disease is not diagnosed. When people learn that they are healthy, they feel positive about themselves and their anxieties about health and sickness abate. A critical bearing of this false sense of security is that further worries, pains and physical symptoms are not given their due importance and additional screening is not sought until it’s too late. Eventually, when they learn about the misdiagnosis, people experience painful feelings of sadness, betrayal and helplessness. They find it hard to accept their condition, do not feel fully responsible for their situation, and are often angry for not being taken seriously.

Bad news is always hard to digest and depending on the severity of the diagnosis, people experience various emotional reactions. Shock, disbelief, numbness and emotional detachment are common immediate reactions to negative results. These are mainly followed by depressed feelings and anger.

Patients with difficult health conditions and their family members need time before accepting the situation and developing a new sense of self which incorporates their health condition. One of the hardest tasks is to break the bad news to family members. Even though family members often offer their support, individuals tend to be concerned about becoming a burden on their families.

Screening for disease carries a negative and clinical connotation. However, health assessments can be perceived as an important part of personal self-care. Self-care is what people do to lead a healthy lifestyle, enhance physical and mental well-being and prevent illness. It also addresses healthy dieting, exercising, adequate stress management and maintaining a healthy balance between life and work. A healthy lifestyle denotes a better quality of life and inspires a sense of being in control.

Certain conditions cannot be prevented – however, unhealthy habits and not caring for oneself result in having to deal with an illness in its advanced stages and delaying major life changes. More often than not, it is more painful to deal with an illness in its advanced stages, particularly if the disease could have been detected earlier.

The early detection of disease is something hard to bear – however it can also instil confidence and a sense of satisfaction, particularly when chances for successful treatment are higher.

Amanda Grech is a registered and European Certified Psychotherapist.