Prostate cancer screening: well intentioned initiatives may use up resources but not improve health outcomes

We read with interest the coverage of prostate cancer screening, particularly the creep of case finding.12 Ironically, the print issue of The BMJ was accompanied by the BMA’s The Doctor magazine, which held an article extolling the merits of a community prostate specific antigen (PSA) testing initiative in south London.3 Although we commend the aim of reducing health inequalities, we do not believe that this will be achieved through a casual non-evidence based testing initiative. The article also referred to liver function and diabetes tests, but it was unclear what guidelines were followed regarding these tests, or the impact on primary care workload of following up such results long term.Unfortunately, this project is reflective of many well intentioned programmes across the country that use scarce healthcare resources without improving outcomes. Anyone considering a screening programme should be fully familiar with the Wilson and Jungner criteria for effective screening and work…
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