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PSA screening for prostate cancer "useless"

It's exactly a year since I last wrote about PSA screening for prostate cancer. This week's BMJ has an article about it ("Prostate screening: is the tide turning against the test?"). This is about an article in The New York Times by the discoverer of PSA, Richard Ablin. He says that the test should never have been approved by the US Food and Drug Administration.

PSA testing, according to Ablin, can't detect prostatic cancer and, even worse, can't distinguish aggressive life-threatening cancer from cancer that will never kill those who harbour it. The test "is little better than a coin toss".

The article has made quite a stir in the USA, where the test is widely advocated and is recommended by the American Urological Association. As usual, financial considerations come into this: PSA testing costs at least $3bn a year and the consequent biopsies and prostatectomies, often unnecessary, generate even more.

In Britain we are more conservative: most experts here say that PSA screening of healthy men is not justified. But the UK Prostate Cancer Charity recently lamented the ignorance of British men about the PSA test and said that this was "completely unacceptable". Which is why I resist appeals for support from this organisation.


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