This session explores the role of patient preferences in cancer screening decisions. Through the lens of recent experiences with mammography and PSA, some may question the roles of decision analysis, economic evaluation and individual preferences. Should we allow informed women under 50 to get screened if they want to after being apprised of the evidence?What about men of any age? Should PSA decisions be informed by preference?When preferences trump evidence, is the role of evidence-based economic evaluation diminished? Discussion will focus on these issues and the translation from research to policy (e.g., guidelines) and policy to individuals (e.g. decision support for patients and providers).