Pandora's Lab: Seven Stories of Science Gone Wrong

by Paul A. Offit

Screening for prostate cancer has also come under closer scrutiny. In 1970, Richard Ablin, a professor of pathology at the University of Arizona, discovered the PSA test, which stands for prostate-specific antigen. PSA is an enzyme made by cells in the prostate gland. The purpose of PSA is to break up cervical mucus so that sperm can enter the uterus. Criminologists were the first to recognize the value of PSA, which offered proof for the existence of semen in rape cases, even when the rapist had had a vasectomy or couldn’t make sperm. Doctors were the next to realize the potential value of PSAs, using the test to determine whether prostate cancers had relapsed. Then physicians took a step they are now starting to regret—PSA tests were used to predict whether someone had prostate cancer. If the level of PSA in the blood was high, then urologists recommended a prostate biopsy. If the biopsy showed prostate cancer, then men either had a total removal of the prostate (prostatectomy) or they had radiation therapy to the prostate. More than 90 percent of men in the United States who have been diagnosed with prostate cancer have had one therapy or the other. Because of the PSA test, prostate cancer is now the most commonly diagnosed non-skin cancer in the United States. So, what’s happened to the incidence of death from the disease? Nothing. The risk of dying from prostate cancer hasn’t changed in the last ten years. Indeed, about 50 percent of men more than 60 years old have be...