What do these differing processes and recommendations tell us about the current state of the art in making guidelines? First, the consistent application of defined methods for gathering, interpreting, and rating evidence promotes transparency and internal consistency. Second, modeling is useful because it integrates different types of evidence to estimate the net benefit of different screening strategies. However, to be most informative, modeling must evaluate all of the relevant strategies and their costs. Third, guideline makers must decide on a process for using modeling results and follow it consistently. Finally, recommendations should be specific about starting and stopping ages, testing intervals, and follow-up. In short, we think the public is best served by a relatively structured, comprehensive, transparent approach in which the entire body of evidence drives the recommendations.