Prostate Cancer Screening; Is This a Teachable Moment?

Abstract

In this issue of the Journal, Welch and Albertsen ( 1 ) presented information that every man considering prostate cancer screening and treatment should know and understand. Prostate cancer screening has resulted in substantial overdiagnosis and in unnecessary treatment. It may have saved relatively few lives. Results from this article and recent results from prostate cancer screening and prevention trials demand reflection about what we as a society have done and are doing. Lessons to be learned have ethical and economic implications and involve our lack of respect for the scientific process and scientific evidence. As I sat down to write this editorial, I heard a radio commercial that brings perspective to the issue. A local celebrity was promoting prostate cancer awareness. He said, “Prostate cancer is 100% curable when caught early.” He encouraged all men to get screened and announced that a van was touring the area offering screening in supermarket parking lots. This was a community service project sponsored by the radio station, the supermarket chain, and a radiation oncology practice. A commercial like this plays to our fears and prejudices. All of us have been taught from an early age that the best way to deal with cancer is to fi nd it early. With the development of the prostate-specifi c antigen test, prostate cancer screening and early detection efforts surged in the United States in the late 1980s and