Screening

Abstract

Primary care providers, including physicians, nurse practitioners, physician assistants, and the people who work with them, operate at the interface of the medical and lay communities. It is frequently stated that one in eight women gets breast cancer sometime in her lifetime. Oncologists consider the care of that one woman and others like her, whereas primary care physicians work with all eight, seven of whom will not get cancer. Oncologists deal directly with the consequences of delayed diagnoses and the morbidity of late-stage diagnoses while primary care physicians see the effects of false-positive tests. The difference in populations affects how each healthcare provider judges the evidence regarding cancer screening and may tip decisions in different directions in the face of ambiguity. However, ultimately the decision to encourage screening does depend on evidence. This chapter is about the evidence-based daily practice of screening in the primary care setting, where providers discuss screening, cancer, and the consequences of each. © 2006 Springer Science+Business Media, Inc.