Conudrum of Cancer Screening: When Should We Screen and When Should We Not?
May 1, 2019
25 Shattuck St.
There is substantial debate over whether and how we should screen the general population to detect cancers such as breast, prostate, and colon cancer. The principle of early detection is attractive and for some patients can be life-saving. Some effective screening programs, like that for cervical cancer, remain under-utilized, particularly in lower-income countries. By contrast, other screening tests (like PSA or thyroid exams) are used despite questionable evidence of benefit, leading to unnecessary procedures and patient stress and morbidity. We will review the cancer screening quandary, including the roles of regulatory authorities and guideline committees like the USPSTF, and consider policies that could help resolve these debates and enhance implementation of effective cancer screening programs in the US and around the world.