Cervical-Cancer Screening — New Guidelines and the Balance between Benefits and Harms

One of the greatest challenges in developing cancer-screening guidelines is devising strategies that maximize screening benefits and minimize screening harms. The benefits of cancer screening — decreased cancer-related morbidity and mortality — are well known and widely promoted; the harms of cancer screening receive less attention and can take many forms: direct complications from screening and confirmatory tests; the expense, anxiety, and life disruptions incurred with new diagnoses with unclear clinical significance; and the prolonged surveillance endured by patients with positive tests but no evidence of disease. Whereas benefits can be maximized by initiating screening early and repeating testing frequently . . .