A Controversial Exposé • Truth Over Profit
Richard Ablin discovered the prostate-specific antigen (PSA) back in 1970. Decades later, he watched in horror as it was hijacked into a mass screening tool. In a blistering New York Times op-ed, Ablin didn’t mince words: the test is “hardly more effective than a coin toss” at distinguishing the deadly cancers from the harmless ones that most men will die with, not from. He called the whole enterprise a “hugely expensive public health disaster” that has wasted billions and subjected millions to unnecessary mutilation.
“I never dreamed that my discovery four decades ago would lead to such a profit-driven public health disaster.” — Richard Ablin, Inventor of the PSA Test
The Numbers Don’t Lie—They’re Criminal
American men face about a 16% lifetime chance of a prostate cancer diagnosis, but only a 3% chance of actually dying from it. Most of these “cancers” are slow-growing slugs that would never cause problems. Yet PSA screening has fueled an epidemic of overdiagnosis.
Studies back this up brutally. Large trials show minimal or no meaningful reduction in prostate cancer deaths from routine PSA testing. One European study suggested a tiny benefit—but it took treating 48 men to save one life, leaving 47 others dealing with the wreckage: incontinence, impotence, and a quality of life in the toilet.
The U.S. spends at least $3 billion annually on this circus, much of it taxpayer-funded through Medicare. And for what? False positives galore. PSA isn’t even cancer-specific—elevated levels can come from infections, benign enlargement (BPH), recent sex, or just getting older. About 75% of men with high PSA don’t have cancer.
This leads straight to the biopsy meat grinder: discomfort, infection risk, bleeding, and more anxiety. Then comes the treatment pressure—surgery, radiation—often for tumors that were never going to kill anyone. Over a million men overdiagnosed and overtreated. Lives ruined for profit.
The Colonoscopy Trap: Another Invasive Cash Cow
If PSA flags something (real or phantom), doctors often escalate to biopsies or push colonoscopies as part of the “full workup.” Don’t get me started on colonoscopies. They’re sold as the gold standard for colorectal cancer, but they’re far from risk-free.
Perforation of the colon, serious bleeding (especially if polyps are snared), anesthesia reactions, infections—these aren’t rare horror stories. Serious complications hit around 3-5 per 1,000 procedures. For older or frailer men, the risks skyrocket while benefits shrink against competing causes of death.
Prep alone is brutal. Sedation means you need a driver. And like PSA, there’s overdiagnosis of polyps that might never progress. It’s another procedure with real downside for marginal upside in low-risk folks.
Real Alternatives That Don’t Destroy Lives
- Watchful waiting / Active surveillance for low-risk findings. Many men with “cancer” on biopsy do fine without treatment.
- MRI-guided approaches: Far better than blind biopsies or old-school digital rectal exams (which studies now call pretty useless for routine screening).
- Risk-stratified, informed decisions: Family history, genetics, symptoms matter. Blanket screening for all men over 50? Junk it.
- Lifestyle hammers: Maintain healthy weight, exercise, eat real food, manage inflammation.
- For colorectal screening: Stool-based tests or blood tests as less invasive starters.
The medical establishment loves to scream “early detection saves lives!” while ignoring the tsunami of harm from overzealous testing. PSA and its follow-on invasive parade exemplify everything wrong with profit-over-patient “preventive” medicine.
Richard Ablin, the inventor himself, wouldn’t get routine PSA screening. Neither should most healthy men. Demand better. Question the script. Your prostate—and your quality of life—depend on it.
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