The Government faces a difficult task convincing people that screening for prostate cancer carries no proven benefit. The Australian Health Technology Advisory Committee concluded this week that “”it does not seem that finding and treating early prostate cancers will increase men’s life expectancy or quality of life.” As a result the Government will not fund a mass screening program.
Overall, that seems like a sensible approach. When the whole population is considered, money spent on prostate-cancer screening could save more lives and reduce more suffering by being spent elsewhere. It may be that screening and treating reduces life expectancy and increases suffering because of their invasive nature. Prostate cancer is usually very slow growing and most men getting it would die from another cause.
That said, 2500 men die of it a year. If discovered early enough it can be cured by removal of the prostate, though that carries a risk of incontinence, impotence, bowel injury and death under anaesthetic. But on an individual level, patients might prefer to take that risk, on medical advice, rather than waiting for symptoms to appear before treatment. If so the question is whether the public should fund it.
A central part of health policy is one of rationing scarce resources. But there is enormous danger in the Government and its advisory bodies applying their population-wide conclusions to funding decisions (which often translate into de-facto medical decisions) in individual cases. Treatment options are best left with doctors and their patients with a Medicare funding safety net.