To screen or not to screen?BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7129.484 (Published 07 February 1998) Cite this as: BMJ 1998;316:484
- Kamran Abbasi, editorial registrar
Kamran Abbasi looks into the war of words over prostate cancer screening
It's that man again. Dr Thomas Stuttaford, medical columnist for the Times and former Conservative member of parliament, has reopened the debate on screening.
In 1995 Dr Stuttaford used his column to advocate a battery of yearly screening tests—from liver function tests to abdominal ultrasound scans—and suggested that these tests would “set your mind at rest,” ignoring the mental distress that screening tests can cause (BMJ 1995;310: 1417). One of the tests he proposed in 1995 was a blood test for prostatic specific antigen (PSA), which is often raised in prostate cancer.
Although asymptomatic, Dr Stuttaford followed his own advice: he had his PSA checked, which was high, and had surgery. On 9 December 1997, as part of the Times Christmas appeal for research into prostate cancer, he described his ordeal with: “A hidden killer that can strike without warning.” He suggested that while radical prostatectomy is a routine procedure in the United States, where screening for prostate cancer is available for people aged over 50, this operation is less common in Britain because of financial considerations. He added that if demand for radical prostatectomy increased in Britain—presumably as a result of a national screening programme—surgeons “may lack the necessary technique” and “anaesthetists may not have …