Almost one third of Americans develop cancer during their lifetime; cancer, in fact, affects three fourths of all families in the United States.2y It is estimated that a significant percentage of cancer deaths could be prevented each year through screening and early intervention. In addi- tion, health care providers, now more than ever before, have the oppor- tunities, skills, and resources to promote health and prevent disease. Yet the delivery of preventive care in the United States remains less than satisfactory. Many reasons have been cited for this lack of attention to preventive care: lack of time in a busy practice, cost, inadequate reimbursement, lack of provider knowledge and interest or disagree- ment with some of the guidelines, lack of patient involvement and knowledge, and lack of office systems that promote preventive care.29

The focus of this article is on the role and use of midlevel providers in cancer screening.Such providers have been shown to be knowledge- able and effective in health promotion and disease prevention activities and can be useful colleagues in ensuring that patients receive the preven- tive care, including cancer screening, that is recommended.