Screening for cancer in adults.

With careful selection of procedures, frequencies and risk groups, the periodic screening of adults for cancer can be a highly cost-effective medical activity. This paper summarizes the evidence of effectiveness of screening, the expected reduction in mortality, the risks and costs of screening, and the cost-effectiveness of screening strategies for cancer of the breast, colon, lung, cervix, endometrium and oral cavity. Some of the most pressing questions to be discussed concern the value of mammography, the frequency of the Pap smear, sigmoidoscopy, the value of chest X-rays and sputum cytology in the detection of lung cancer, and the current status of screening for cancers of the endometrium and oral cavity.