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A case against prostate screening from a scientist who made it possible

What do pathologist Richard J. Ablin and science writer Ronald Piana think about routine PSA screening for prostate cancer? The title of their new book offers a pretty good clue: “The Great Prostate Hoax: How Big Medicine Hijacked the PSA Test and Caused a Public Health Disaster.”

The authors say that screenings for prostate-specific antigen, or PSA, result in “a million needle biopsies per year, leading to more than 100,000 radical prostatectomies, most of which are unnecessary” and whose side effects can include incontinence and impotence.

It’s a familiar criticism, but Ablin is an unusual critic: He describes himself, and is often cited, as having discovered the antigen in 1970. (As is often the case in modern science, many independent researchers can claim some role in the discovery.)

The debate over the PSA test is ongoing, and experts are careful about what they say. The National Cancer Institute, for example, says, “Although some organizations continue to recommend PSA screening, there is widespread agreement that any man who is considering getting tested should first be informed in detail about the potential harms and benefits.” There’s no doubt that any concerned man could get a powerful and passionate argument against the test from this book.



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