U.S. health care is expensive by any standard, and for years routine screening for cancer has come under attack by critics who feel that the risk and cost of testing outweighs the benefit.

This month, two medical organizations, in a stunning reversal of prior policy, changed recommendations for breast and cervical cancer screenings.

The U.S. Preventive Services Taskforce recommended delaying breast cancer screening, reversing well-established guidelines by the American Cancer Society that recommended yearly mammograms after the age of 40.

In another tectonic shift, the American College of Obstetricians and Gynecologists recommended reducing screening for cervical cancer to once every two years instead of annually for women ages 21 to 30.

Dr. Elizabeth Street, a Fellow of the American College of Obstetricians and Gynecologists, disagrees with the new policy.

"Cervical screening by Pap smears is not perfect. You may miss 30 percent of whatever is there in a routine test and the next year you might pick up a cancer," Street says. She is also concerned that many may not make an appointment for screening at all if the interval is increased to two years.

Dr. Phil Israel, a noted specialist in the treatment of breast cancer, adamantly disagrees with the new policy on breast cancer screening.

"You do not make these momentous changes overnight. This is a huge change in practice," Israel says. "This is such a drastic and sudden reversal of policy and the task force made these recommendations without any dialogue with the American College of Surgeons, the American Society of Breast Surgeons or the American College of Radiology, and it was way too much too fast."

Not consulting with noted organizations that deal routinely with the serious issue of cancer is regrettable.

Both of these surgeons are telling patients that they are making no changes based on the new recommendations and that any changes should be carefully studied because of their immense impact.

The fact that some individuals have benefited from screening is undeniable. Asymptomatic and silent breast and cervical cancers have been diagnosed, treated and cured, enabling many to escape the personal tragedy of uncontrolled and incurable cancer.

Screening for cardiac disease has been criticized as well, based on the rationale that screening is expensive and that the risks may outweigh the benefits.

Expensive, yes, but how do you weigh the emotional and personal benefits of a cancer or cardiac abnormality that is diagnosed on routine screening and that results is a serious cure?

Jeff Smoot, an employee of WellStar Health System, made the momentous decision to undergo "routine" cardiac screening.

Smoot says, "I had no risk factors at all. I work out five times a week. I had the cardiac screening test and I was told I had a potentially fatal heart condition."

His heart abnormality was completely silent and Smoot was totally asymptomatic.

After the routine cardiac screening, Smoot was seen by Dr. Arthur Reitman, a cardiologist with WellStar Health System. Again he was diagnosed with the potentially fatal condition. Further testing revealed that a portion of his heart was not receiving enough blood flow due to an abnormal artery.

Utilizing minimally invasive robotic surgery, Dr. William Cooper, Medical Director of Cardiovascular Surgery at WellStar Health System, successfully performed surgery. The artery was rerouted, blood flow was restored to a vital portion of Mr. Smoot's heart and today, he enjoys an active lifestyle.

Jeff Smoot was cured of a silent condition. Try and "counsel" Mr. Smoot that his screening was unnecessary and too expensive and I am sure his response will be one of disbelief.

Silent conditions are why we perform cardiac, cervical and breast cancer screenings. Screening for silent conditions is why many today are cancer and disease free.

Screening is expensive when applied to entire populations.

Cancer is expensive too and so is heart disease.

Jeff Smoot puts it quite succinctly. "You can minimize the risk factors but what you don't know can kill you."

I like knowing.