Table 3.

Recommendations for cancers that are not routinely screened in the general population^a

Cancers	Recommendations	RCT Evidence of Screening that Earlier Intervention Works			Test Performances		Cost-Effectiveness, ICER ($/LYS)
		Trials (n)	Participants (n)	Results	Sensitivity (%)	Specificity (%)
Prostate	No general consensusUSPSTF found no evidence to recommend for or against routine screening using PSA and DRE (84)	2 (88)	57,511	No significant mortality reduction in the intervention group	PSA 72.1 (CI 66.7 to 100.0) (88) DRE 53.2 (CI 49.0 to 69.2) (88)	PSA 93.2 (CI 63.1 to 100.0) (88) DRE 83.6 (CI 18.0 to 99.5) (88)	65,000 to 125,000 (93)
	ACS recommends annual screening using PSA and DRE in men older than 50 (18)
	The American College of Physicians made no firm suggestions about screening and believes that the decision to screen should be individualized (85)
Hepatocellular	No firm recommendation; however, screening using α-fetoprotein testing and abdominal ultrasound should be considered in high risk individuals (13)	2 (78)	19,884	No significant mortality reduction in the intervention group	α-Fetoprotein68.6 (78) Ultrasound 84.3 (78) Both 60.8 (78)	α-Fetoprotein 95 (78) Ultrasound 97.1 (78) Both 95 (78)	112,993 to 284,000 (82)
Lung	No recommendation	6 (using CXR and/or sputum exam) (71)	103,441	No significant mortality reduction in the intervention group	No data	No data	19,000 to 62,000 (99)
Renal	No recommendation	No RCT to show screening using renal ultrasound improves cancer-specific and overall mortality	No data	No data	No data
Skin	Insufficient evidence to recommend for or against total body skin examination (64)	1 RCT using total body skin exam is now under way (65)			Total body skin exam 94 (100)	Total body skin exam 98 (100)	29,170 to 50,000 (66)

^aACS, American Cancer Society; CXR, chest x-ray; DRE, digital rectal examination; PSA, prostate-specific antigen; RCT, randomized, controlled trial; USPSTF, US Preventive Services Task Force.