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Creator of prostate cancer screening test laments the mis-use of his invention

Richard Ablin is a professor of immunobiology and pathology at the University of Arizona College of Medicine.  Back in 1994 he secured approval for a screening test that identified an enzyme made by the prostate and could be an indicator of prostate cancer.  His test was called the prostate-specific antigen, or P.S.A. test and is now standard annual fare for men over 50.  Ablin wrote an op-ed piece, recently, in the New York Times, in which he lamented how his invention has now become a money-generating "fee for service" behemoth which is destroying more lives than it helps.

 Ablin noted that subsequent research has clearly established that as a "screening device" the PSA test has led to hugely invasive surgeries, radiation and intensely complicated procedures for nearly 50 men for every life it saves by the detection and successful treatment of a would-have-been fatal cancer.  Unfortunately, many of those fifty "other" patients suffer complications that are fatal, life-shortening, or significantly life-impairing, so that the cost of PSA screening probably out-weighs the benefits for a vast majority of men.  

Since the PSA cannot distinguish potentially fatal prostate cancer from the significant majority of non-life threatening forms, it has resulted in a culture of over-treatment of a disease that is so benign and slow growing that it will not kill most of its victims.  Ablin calls his own invention a "hugely expensive profit-driven public health disaster."  It detects only 3.8 percent of prostate cancers in patients--slightly better than digital rectal screening results. 

Recent studies in Europe and America published in the New England Journal of Medicine documented that all of this intensive screening and treatment had not improved the prostate cancer survival rate over the past 7 to 10  years.  The most respected health care voices in America are cautioning against this screening or outright rejecting it, with only the Urology specialty society still recommending it unflinchingly.   Yet Medicare and the VA spend more than $3 billion dollars per year on PSA screening:  while 16 percent of American men will suffer from prostate cancer in their lifetime, only 3 percent will die from the disease.  (You're far more likely "to die with the disease than to die of it," in the author's words.)

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