Letter: Ban on screening unfair to men

Click to follow
The Independent Online
Sir: It has become a cliche in articles about prostate specific antigen (PSA) screening to quote the undisputed fact that many men who harbour malignant cells in their prostate die of something else before the prostate cancer kills them ("Prostate screening ruled out by NHS", 7 February).

Some doctors go on to argue that PSA screening is uneconomic or positively harmful, because it identifies men who may not be destined to die of the disease and spreads anxiety (and presumably would cost the NHS money).

The only way that this cancer can be cured is if it is diagnosed at an early stage while it is still confined to the prostate. While this may be discovered by accident, the only deliberate way of testing for the possibility of the disease is by PSA.

Because many men do not die of the disease, the NHS concludes that early diagnosis should be denied. The consequence is that the 8,500 men who will die from prostate cancer every year in this country should not be cured - ie the NHS is refusing to cure many people bound to die painfully because a larger number with the same disease will die of something else. This is terrible logic, cannot be good medicine and is surely immoral.

The US Federal Government some years ago commissioned an exhaustive study of PSA testing from a public health point of view which took a very hard look at the economics of national PSA screening.

The study, which is publicly available, basically concluded that so long as the treatment was nationally as effective as it was at the better medical centres, PSA testing was economic and could be supported by Medicare.


London W1