COMMENTS: Prostate Cancer Screening

The New York Times inspired both ABC and NBC to cover the public health issue of screening for cancer. The newspaper quoted Dr Otis Bradley, the chief medical officer of the American Cancer Society, as warning that the advantages of screening for prostate and breast cancer--with PSA blood tests and mammograms--"have been exaggerated." NBC's Robert Bazell noted that the Times had reported that the ACS was "quietly working" on a revision for its guidelines about screening. This scoop was contradicted by the society's official announcement that no revisions are planned. ABC's Sharyn Alfonsi picked up on the reaction that it would be "a disastrous public health message to let people believe cancer screenings are useless." This piece of reporting is a straw man. Dr Bradley never called screenings "useless"--suggesting merely that their benefits are exaggerated.

ABC's exasperated anchor Charles Gibson called in his network's in-house physician Timothy Johnson (at the tail of the Alfonsi videostream): "I am left with this confusion," he complained. "It seems to me what you are talking about--what is uncertain--is what you do after the screenings; not a question of whether you should have the screenings themselves but, then, what kind of treatment should come after you spot the cancer." Dr Johnson's reply: "These tests do what they are supposed to do, in most cases. They find the cancers. The problem is that we do not know which ones to treat--which ones are going to be lethal--so we overtreat."

By the way, both ABC's Dr Johnson and NBC's Bazell pointed out that these concerns about screenings do not apply to pap smears or to colonoscopies.

This controversy comes at a time when my friend Jeff Jarvis has just undergone prostate cancer surgery after testing PSA positive. Jarvis has discussed his diagnosis, his surgery, its impact on his penis and the public health question of PSA testing at his Being a prostate cancer surgery patient myself, I have joined in those discussions in his comments.


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