What Urologists Have Taught Us About Screening & Incidental Detection in Cancer

Ramon Guiteras Lecture at the 2026 annual meeting of the American Urological Association, Washington, DC. Take-home points: 1. Look harder, find more Corollary: the observed incidence of cancer is some function of how hard we look 2. Look harder, find more & the typical patient appears to do better Corollary: deceptive feedback triggers a cycle of increasing intervention 3. More than most specialties, urology has acknowledged the problem of overdiagnosis – and taken steps to address it 4. Screening involves value judgments: trading off the frequent near-term harms vs. the rare possibility of future benefit Corollary: it’s hard to make a well person better…