The full content of Annals is available to subscribers

Subscribe/Learn More  >
Editorials |

Deciding about Screening

Stephen G. Pauker, MD
[+] Article, Author, and Disclosure Information

New England Medical Center, Tufts University School of Medicine, Boston, MA 02111. Requests for Reprints: 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.

Copyright 2004 by the American College of Physicians

Ann Intern Med. 1993;118(11):901-902. doi:10.7326/0003-4819-118-11-199306010-00013
Text Size: A A A

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 ovarian cancer, factoring in the discomfort and potential inconvenience of venipuncture and transvaginal sonography can eliminate the small benefit of the program. Taking the time and energy required to organize relevant data in constructing a decision analytic model can provide important insights into the usefulness of such screening programs.

First Page Preview

View Large
First page PDF preview





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.