warranted, then it would follow that broad-based population screening should be advocated. In reality, seeking and reporting of incidental findings represents a form of “opportunistic screening”36 that has a long history in clinical medicine. When patients complain of symptoms in the digestive system, the well-trained physician examines cardiac and respiratory systems as well, both for clues to a multi-system disease and to incidentally discover any unrelated signs. When radiographs are read for a particular anatomical focus, the radiologist scans the entire radiograph and also reports on abnormal findings in regions not indicated as the primary reason for the study. In these situations, unlike population screening with its requirement of extensive cost and infrastructure, the patient has already presented to the medical care system, has been evaluated and is under the care of a clinician. Moreover, much of the cost of the study and any associated risk has already been sustained for the primary indication, lowering the cost/risk-to-benefit ratio for the discovery of incidental findings.
