Which statement best describes a testing cascade?

Which statement best describes a testing cascade?

• A. A test with no follow-up leads to harm
• B. A single test
• C. A test cascade never harms
• D. One test → incidental finding → more tests → harm

Answer: (D)

A testing cascade happens when one test leads to an incidental finding or result that triggers additional tests and procedures, and those downstream steps can cause harm. The best description captures that progression: starting with a single test, an incidental finding prompts more testing, and the accumulated tests and interventions can lead to harm from invasive procedures, false positives, anxiety, or exposure to radiation. For example, a routine screening test might uncover an unrelated finding that leads to additional imaging or biopsy, which can cause complications or unnecessary treatments. The other options don’t describe this chain of events: a test with no follow-up lacks the cascade of further testing; a single test by itself isn’t a cascade; and cascades can indeed cause harm, so saying they never harm is inaccurate.

A testing cascade happens when one test leads to an incidental finding or result that triggers additional tests and procedures, and those downstream steps can cause harm. The best description captures that progression: starting with a single test, an incidental finding prompts more testing, and the accumulated tests and interventions can lead to harm from invasive procedures, false positives, anxiety, or exposure to radiation.

For example, a routine screening test might uncover an unrelated finding that leads to additional imaging or biopsy, which can cause complications or unnecessary treatments. The other options don’t describe this chain of events: a test with no follow-up lacks the cascade of further testing; a single test by itself isn’t a cascade; and cascades can indeed cause harm, so saying they never harm is inaccurate.