What’s wrong with free prostate-cancer screening?

Sep 14, 2009 5:24 PM

At a New York Yankees game I went to last week, the team gave free Snoopy dolls to fans—and a charity offered free prostate-cancer screening to men age 40 and up. I’m sad to say I got there too late for one of the dolls. But I’m glad I passed on the blood test for prostate cancer.

Why? Well, for one thing it would be a tad bizarre having a blood sample taken at a ball game. More important, though, is that deciding whether to get tested for prostate cancer is a surprisingly complicated matter. That’s because there’s still no proof that screening for the malignancy saves lives overall, and considerable evidence that it can lead to unnecessary medical procedures that can cause impotence, incontinence, or both. That doesn’t mean that all men should necessarily skip the test. But it does mean that the decision should be a considered one—one that involves researching the risks and benefits of the PSA blood test, understanding the limitations of prostate-cancer treatments, and having an honest and thorough talk with your doctor. None of those things, it goes without saying, is particularly easy to accomplish at a baseball game.

Unfortunately, all too often getting screened for prostate cancer is presented as a no-brainer, with none of those counter arguments. For example, during this year’s U.S. Tennis Open the former tennis star John McEnroe has been promoting prostate-cancer screening for men as young as age 40, citing new recommendations from the American Urological Association. But during his appearances on CNN’s Larry King Live and the Early Show on CBS, there’s been no mention that most organizations, including the American Cancer Society and the United States Preventive Services Task Force, emphasize that the evidence for the test is sketchy. As a result, those organizations say that men should discuss the pros and cons of the test with their doctor.

Nor was it mentioned on the Early Show that McEnroe was being paid for his efforts by the pharmaceutical giant GlaxoSmithKline—which just happens to make dutasteride (Avodart), a prostate medication. And the Web site he promotes during those appearances, no surprise, is also funded by the drug maker. That Web site links to a number of free screenings at golf tournaments, football games, and other sporting events. My advice: Sure, learn all you can about prostate cancer—but not at events funded by drug makers, where you’re likely to hear only one side of the story.

—Joel Keehn, senior editor

Read more on the risk factors for prostate cancer. And if you've been diagnosed, take a look at our list of questions to ask your doctor.