This should be a matter of individual choice. The patient should read the pros and cons, the risks associated with each option, and decide for him/herself the best course of action. Your doctor is your paid consultant and employee (follow the cash flow), not your boss. Likewise, the last time I checked the most famous short-and-sweet speech ever given, this is a "government of the people, by the people, and for the people," so it really should not be up to Uncle Sam to decide what screening or treatment is appropriate for you.

Irrespective of what one decides regarding screening and treatment, there is no substitute for prevention, and we do now know enough to make conservative, sound dietary and lifestyle recommendations which significantly reduce the risks and progression rates of various diseases. Bad things will always happen to good people who do every thing right, but we can manipulate the odds in both directions.