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Biometrika 1969 56(3):601-614; doi:10.1093/biomet/56.3.601
© 1969 by Biometrika Trust
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On the theory of screening for chronic diseases

M. ZELEN and M. FEINLEIB

State University of New York at Buffalo
National Institutes of Health

It is assumed that a chronic disease progresses from a pre-clinical state to a clinical state. If an individual, having pre-clinical disease, participates in an early detection programme, the disease may be detected in the pre-clinical state. The potential benefit of a screening programme is related to the lead time gained by early diagnosis. A stochastic model is developed for early detection programmes which leads to an estimate of the mean lead time as a function of observable variables. An investigation is also made of a non-progressive disease model in which individuals in a pre-clinical state may not necessarily advance to the clinical state.


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