The argument has raged for some time and shows no sign of abating any time soon: screening for diseases, yes or no? Take the case of prostate cancer screening: Richard Ablin - the author of “The Great Prostate Hoax”, and the man who claims to be the first to have identified PSA (a protein created by the walnut-sized prostate gland that can easily be measured) - maintains that PSA testing can do, and often does, more harm than good. Ablin, of the University of Arizona, has noted that a man’s PSA levels may be high but that doesn’t mean that he has cancer. On the reverse side of the coin, a low PSA level doesn’t necessary mean that a potential patient’s worries are over in this regard.Yet the fact remains that around one-in-three men aged from 40-60 has traces of prostate cancer, and the risk rises with ageing. So all men should be regularly tested, right? Well, not necessarily… Ablin and others argue that over-testing can very easily lead to over-treatment, including unnecessary invasive surgery to remove the prostate gland. The over-treatment argument has also been used in respect of breast cancer screening, although the figures tend to show that it works very well in a preventative sense and even better in detecting early breast cancer in target age groups. Yet over-treatment is clearly an issue, with many women (plus those aforementioned men with early ‘signs’ of prostate cancer) simply wanting all traces of the disease, or potential disease, removed right away, regardless of the potential cost to them personally or, indeed, fiscally to society in general. So over-treatment is clearly something that cannot be side-stepped. The counter-arguments - and they are very strong ones - is that our ‘social contract’ has obligations to ensure the highest standards possible regarding...