I am continuing my criticism of journalists and news organizations that crusade for screening tests – seemingly oblivious to the controversies and the debates that swirl around many of these screening tests. When a news organization takes an advocacy stance for a controversial cause, it should know the facts and the facts are that some people will be hurt by their advocacy efforts.
The latest example is the Chicago Sun-Times, which is sponsoring free prostate cancer screenings throughout the Greater Chicago area this week. A Sun-Times news release states: “Men ages 40 and older are urged by the health officials to take advantage of the screenings, which include a PSA blood test and a digital rectal exam.
But the U.S. Preventive Services Task Force (USPSTF) – perhaps the nation’s best, unbiased, balanced source on such questions concludes “that the evidence is insufficient to recommend for or against routine screening for prostate cancer using prostate specific antigen (PSA) testing or digital rectal examination (DRE).”
But the Sun-Times didn’t stop by sending out news releases. It ran a story about its own campaign.
The story stated, under the heading “GET TESTED” – “Men ages 40 and older can stop by one of the mobile clinics for the free, private prostate cancer testing and physical exam.”
The USPSTF tells men that “screening is associated with important harms, including frequent false-positive results and unnecessary anxiety, biopsies, and potential complications of treatment of some cancers that may never have affected a patient’s health. The USPSTF concludes that evidence is insufficient to determine whether the benefits outweigh the harms for a screened population . Screening may result in harm if it leads to treatments that have side effects without improving outcomes from prostate cancer, especially for cancers that have a lower chance of progressing. Erectile dysfunction, urinary incontinence, and bowel dysfunction are well-recognized and relatively common adverse effects of treatment with surgery, radiation or androgen ablation.”
John Cruickshank, Sun-Times News Group Chief Operating Officer, is quoted in his news release saying, “The program demonstrates how the Chicago Sun-Times provides our readers with important, and in this case, life-saving information for residents of the Chicago region.”
The story should be that the Chicago Sun-Times ignores the best evidence in promoting prostate screening to all men – and in promoting it to men in their 40s, they have not only taken an advocacy stance but a radically aggressive stance that may find a few cancers but will also certainly expose some men to unnecessary harms. One can only wonder what the informed consent form looks like during these quickie exams (20 minutes, says the news release) in these mobile clinics.