Commentary: Medicalisation of risk factors

摘要

A middle aged man with pneumonia may wonder why the attending doctor is inserting a finger into his rectum. This is a screening test-it has nothing to do with the patient's disease. The physician may find a localised prostate cancer, and the patient may subsequently undergo radical prostatectomy, although no evidence from randomised trials shows that this operation is effective. The patient with pneumonia cannot be sure that the prostatectomy will increase his chance of living longer, but his life will probably feel longer, because the operation renders most men impotent. This disastrous consequence has received too little attention, but when properly informed, many men will decide not to have a screening test.