Waiting for Evidence

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This is an argument that some people make. The fact that there is as yet no evidence that screening saves lives isn't the same as if there was evidence that screening does not save lives. Therefore, why wait for proof if some men with early prostate cancer could be identified and saved by having their prostate removed.

If there were no harms associated with this practice, and if there were effective treatments, this would be fine. But, unfortunately, this is not the case.

• First, many healthy unsuspecting men will be incorrectly told that they have prostate cancer when they really do not. This causes anxiety, in addition to the inconvenience, cost, and discomfort of a needle biopsy to confirm their freedom from disease.
• And, some insignificant cancers will be found and treated that would never have caused problems.
• Treatment, especially potentially curative surgery, can cause problems that affect a man's future quality of life, most importantly sexual and urinary problems.
• Finally, there is little evidence that treatment really does save lives.