Deciding about Screening

Editorials1 June 1993Deciding about ScreeningStephen G. Pauker, MDStephen G. Pauker, MDNew England Medical Center, Tufts University School of Medicine, Boston, MA 02111.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-11-199306010-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail As shown in an accompanying article, the benefits of any broadly based screening program for ovarian cancer are limited more by the low prevalence of disease than by the potential benefits of treating early disease or the performance of currently available tests. Screening for such diseases is best restricted to special populations at markedly increased risk. In low-prevalence populations, false-positive results and the costs and risks of the workups they induce are magnified. In determining the marginal cost-effectiveness ratio of such programs, failure to consider even apparently minor factors can markedly affect the conclusions. In the case of screening for ...References1. Schapira MM, Matchar DB, Young MJ. The effectiveness of ovarian cancer screening: a decision analysis model. Ann Intern Med. 1993; 118:838-843. Google Scholar2. Kassirer JP, Pauker SG. The Toss-up. N Engl J Med. 1981; 305: 1467-9. Google Scholar3. Tsevat J, Weinstein MC, Williams LW, Tosteson AN, Goldman L. Expected gains in life expectancy from various coronary heart disease risk factor modifications. Circulation. 1991; 83:1194-201. Google Scholar4. Eddy DM. Screening for cervical cancer. In: Common Screening Tests. Philadelphia: American College of Physicians; 1991:255-85. Google Scholar5. Eddy DM. Screening for breast cancer. In: Common Screening Tests. Philadelphia: American College of Physicians; 1991:229-54. Google Scholar6. Morrison AS. Screening in Chronic Disease. New York: Oxford University Press; 1992:154-65. Google Scholar7. Helzlsouer KJ, Bush TL, Alberg AJ, Bass KM, Zacur H, Comstock GW. Prospective study of serum CA-125 levels as markers of ovarian cancer. JAMA. 1993; 269:1123-6. Google Scholar8. Granai CO. Ovarian cancerunrealistic expectations. N Engl J Med. 1992; 327:197-200. Google Scholar Author, Article, and Disclosure InformationAffiliations: New England Medical Center, Tufts University School of Medicine, Boston, MA 02111.Corresponding Author: Stephen G. Pauker, MD, Box 302, New England Medical Center, Boston, MA 02111.Grant Support: In part by grant LM 4493 from the National Library of Medicine and grant HS 06503 from the Agency for Health Care Policy Research. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Hypertension after Ambulatory Blood Pressure Monitoring Jennifer M. Grin , Ellen J. McCabe , and William B. White Metrics Cited ByThe Combination of Fasting Plasma Glucose and Glycosylated Hemoglobin as a Predictor for Type 2 Diabetes in Korean AdultsUndetected type 2 diabetes in older adultsA Quantitative Methodology for Determining the Need for Exposure-Prompted Medical MonitoringIncreasing incidence and pretransplantation screening of hepatocellular carcinomaDrug Utilization Review: Mechanisms to Improve Its Effectiveness and Broaden Its ScopeThe effectiveness of a clinical practice guideline for the management of presumed uncomplicated urinary tract infection in women∗11This work was completed while Dr. Saint was a Robert Wood Johnson Clinical Scholar.Cost-effectiveness of screening for detection of small hepatocellular carcinoma in western patients with Child-Pugh class A cirrhosisScreening for acquired cystic kidney disease: A decision analytic perspectiveScreening for ovarian cancerEnthusiasm Misplaced? 1 June 1993Volume 118, Issue 11Page: 901-902KeywordsCancer screeningCancer treatmentLaparotomyLife expectancyMorbidityOvarian cancerPhlebotomyPopulation statisticsSpecificityUltrasound imaging Issue Published: 1 June 1993 CopyrightCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...