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PSA choice a folly too far

There are some areas of health care where an ideological commitment to patient choice appears to have won out against good clinical sense.

There are some areas of health care where an ideological commitment to patient choice appears to have won out against good clinical sense.

Allowing healthy men to decide whether they should have a PSA test is one. Most cancers detected would never have harmed the patient ­ whereas sadly, the same cannot be said for invasive follow-up care.

But the debate over PSA testing took a new twist this week, as it emerged that the test results not only fail to predict the likelihood of having invasive cancer, but often fail to predict anything much at all. PSA testing is 'unacceptably' erratic, with errors having a 'significant impact' on the quality of patient care, a new study has found.

Government advisers reacted robustly, insisting healthy men should not have the PSA test. But in a country scared stiff of cancer, it is hardly surprising more and more men are opting for it.

The Government's guidelines are ridiculous and put GPs under unacceptable pressure from patients.

It is time to acknowledge the limits of patient choice and hand back this decision to the doctor.

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