It's State Fair time in Minnesota - a grand time at one of the nation's best state fairs. Every year, the NBC station in the Twin Cities, KARE-11, offers free health screenings at the fair. TV stations love such events. And this year the added touch was the fact that the big "Drive Against Prostate Cancer" mobile screening unit rolled onto the fairgrounds outside the KARE-11 building. It's well-intentioned but it's not as simple an idea as the TV station marketing people probably think it is.
Now, if KARE really cared about the issue, it would have a shared decision-making booth at the entrance to the screening van. Because prostate cancer screening isn't simply a matter of "Drop the corn dog, cheese curds or hot-dish-on-a-stick and have a PSA test." But that's the way it comes across in the setting of mass screening on the fairgrounds. There are a few things a man should think about seriously before rolling up his sleeve for the supposedly "simple" blood test.
But here, prostate cancer screening is hawked in the same setting as the modern-day carnies pitching their slice-'em-and-dice-'em devices and inventions you only see at the state fair - "only at this price today!"
Maybe KARE should play on its TV monitors this video of American Cancer Society chief medical officer Otis Brawley, MD, who says, among other things:
"I'm very concerned. There's a lot of publicity out there - some of it by people who want to make money by recruiting patients - that oversimplifies this - that says that 'prostate cancer screening clearly saves lives.' That is a lie. We don't know that for sure......We're very concerned about a number of clinics that are offering mass screening where informed decision making - where a man gets told the truth about screening and is allowed without pressure to make a decision - that's not happening. Many of these free screening things, by the way, are designed more to get patients for hospitals and clinics and doctors than they are to benefit the patients. That's a huge ethical issue that needs to be addressed.
We're not against prostate cancer screening. We're against a man being duped and deceived into getting prostate cancer screening."
Addendum: A quick web search shows that state fairs in Kentucky, South Dakota, Idaho, Kansas, Virginia and Wisconsin also have offered prostate cancer screenings. There are probably many more.
Search for Civility, Shared Decision-Making in Screening/Health Care Discussions - Gary Schwitzer follow-up post/comments