Americans are enthusiastic about screening, especially cancer screening.1 What could be wrong with screening, especially if it can detect a life-threatening condition at an earlier stage? Trials show that early detection of breast, colorectal, and other cancers can reduce cause-specific mortality rates, and the same could apply to other conditions. With presumably little to lose and much to gain from early detection, why recommend against screening unless the concern is costs? Are lives being lost to save money?