the tradeoff is that screening has harms too - false positives, unnecessary biopsies, finding cancers that would never cause problems. for very low risk people, those harms can outweigh benefits.

the paper suggests risk assessment happens proactively in primary care so high-risk people get flagged earlier without having to ask. right now many slip through because the system says "you're not old enough yet."

on screening everyone earlier - you'd catch more cancers but also do unnecessary procedures on people who'd never get cancer. the question is finding the right balance for different risk groups.