Cancer screening strategies must strike a delicate balance between benefits and harms. While the population at large is familiar with cancer screening benefits, screening harms are often not appreciated and generally not discussed. Harms can take many forms, including pain, inconvenience, and morbidity associated with all aspects of screening: testing, follow-up procedures, and treatments. In addition, prolonged surveillance among those with diagnoses of uncertain malignant potential can lead to substantial life disruptions and anxiety. Defining the optimal balance between benefits and harms is often difficult but imperative so that screening benefits are maximized and screening harms minimized.1