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Questionable medical advice in TV drama

In Sunday's episode of Down To Earth on BBC1, the central character, Tony, went to get the results of his prostate biopsy. He was having this because his GP had done a test for PSA (prostate specific antigen) and found it to be raised. The biopsy result, predictably, was normal: Tony didn't have cancer. He therefore told the consultant that he thought he'd wasted his time by having the test. "Not so," the consultant replied; "it's a good thing to do and if more men had it we would catch their cancers earlier and be able to cure them"

In other words, the programme was endorsing the value of prostate cancer screening for everyone. What the GP didn’t tell Tony was that there is a large overlap between normal and abnormal levels of PSA, and what the consultant didn't say is that many men with prostate cancer will never have any problems from it and will die of something else; moreover, at present there is no consensus about the best way to treat this cancer once it has been diagnosed or even if it should be treated at all rather than watched. The value of screening for prostate cancer with the current available methods is therefore uncertain at best. It seems irresponsible to put out advocacy for screening in a programme of this kind.

Here are some references to discussions of this question:

1. Prostate cancer intervention.

2. Prostate test "of little value"

3. Trials of treatment needed first.


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