The premise is on page 127: “The prostate cancer industry is herding countless numbers of men via PSA screening into a system that renders them incontinent and impotent.” The book alleges that there is much evidence of harm caused by mass PSA screening and little or no evidence of benefit to men. The benefits accrue as profits to the prostate cancer industry and its offshoots. Much of this book is concerned with the money links of the prostate cancer industry, its “profits-over-patients ethos.” The PSA test is not specific for prostate cancer. It provides many false positives. It is as accurate as a “coin toss,” says the author, but its consequences can be life changing.

In fact, the PSA is typically only one of a series of diagnostic tests. It can suggest that there is a problem, but the life-changing consequences follow from other tests and procedures. It is “the system” that renders men incontinent and impotent, not the PSA test, which is not dangerous if used ethically, within its limitations. This book alerts readers to those limitations. The PSA leads to more tests, not to the life-changing maiming of men. Granted that those additional tests may be profitable for doctors and unnecessary. Granted that biopsies are painful and may not be necessary. But the serious damage is not coming from the PSA test.

The two authors are a professor of pathology and a science writer specializing in oncology. The former was allegedly the discoverer of the PSA antigen in 1970.

A point of view with implications! This book is worthy of consideration, but the PSA test is not harmful in itself. The harm is in the overestimation of its importance. ( )