Screen no matter the risk?

The systematic review by Naomi Tan and colleagues published in The Lancet Public Health (February issue) on the perceptions of personalised risk-based cancer screening reflects a growing trend in the field, with a risk-based approach seemingly being the future of cancer screening.¹ In an era of personalised medicine and precision public health, there is considerable appeal in tailoring cancer screening according to individual risk. By identifying and screening people at high risk of cancer who are likely to benefit the most from screening, the hope is to maximise cancer-specific mortality reductions without exposing people who are at low risk—and unlikely to benefit from screening—to potential harms.1, 2 This approach represents one strategy for preventing low-value, population-based screening.³