Screening with Imaging: Principles, Technical Considerations, and Cost-Effectiveness.

Evaluating the effectiveness of imaging-based screening requires understanding of diagnostic performance, disease prevalence and incidence, and appropriate measures of benefits and harms. Multiple screening programs based on imaging tests have been broadly implemented, for both cancerous and noncancerous abnormalities. Breast cancer, and more recently prostate cancer and colorectal cancer screening programs have seen an increased role for imaging. In this article, we review principles underlying imaging screening programs, provide an overview of established imaging-based screening and technical considerations, and describe how cost-effectiveness principles apply to screening evaluation.