UNINFORMED CONSENT: MASS SCREENING FOR PROSTATE CANCER
Article first published online: 17 MAY 2010
© 2010 Blackwell Publishing Ltd.
Volume 26, Issue 3, pages 143–148, March 2012
How to Cite
JUSTMAN, S. (2012), UNINFORMED CONSENT: MASS SCREENING FOR PROSTATE CANCER. Bioethics, 26: 143–148. doi: 10.1111/j.1467-8519.2010.01826.x
- Issue published online: 3 FEB 2012
- Article first published online: 17 MAY 2010
- informed consent;
While medicine may agree in principle that cancer screening requires informed consent, such consent is not, in fact, common practice. In the case of prostate-cancer screening this means that men in large numbers undergo PSA testing with little understanding of its liabilities – in particular, that it may or may not decrease mortality, often detects cancer of questionable significance, and may lead to unnecessary surgery. Given that prostate cancer is known to be overtreated and that family history is a risk factor, it follows that a man diagnosed with prostate cancer, even if it is of no clinical significance, automatically promotes his son into the high-risk category; and given that those so categorized are subject to heightened medical surveillance and that the more diligently medicine searches for prostate cancer the more likely it is to find it, it follows that the sons of men diagnosed as a result of PSA testing are at risk of being overdiagnosed (and overtreated) precisely because their father was. Twenty years into the PSA revolution, its generational consequences have not been discussed in the medical literature.