28) D

The passage tries to convey the message that routine health screening is not always the best option and targeted screening programmes are more beneficial.

Option A only discusses about better off people leading healthier lifestyles. However, the passage does not only focus on better off people.

The value of universal screening programmes has not be underestimated at all and this is not suggested by the passage. This is why B is wrong.

Option C only focuses on breast cancer screening whilst the passage only used breast cancer screening as an example. So C is wrong.

D is correct because the last line of the paragraph clearly implies that instead of universal screening programmes, targeted screening programmes are more beneficial.