Re "We Should Stamp Out This Medical Misinformation," Commentary, June 28: Steven Woloshin and Lisa Schwartz are critical of the post office for embarking on a prostate cancer educational campaign. Although the efficacy of prostate cancer screening is uncertain, the same can be said for nearly all cancer screening methodologies.
Despite extensive screening regimens for many years, the overall mortality for breast cancer remains at approximately 25 deaths per 100,000 population, a figure that has not substantially changed since 1930. Although there have been studies demonstrating the efficacy of breast cancer screening, the fact that the overall mortality has not changed in the population suggests that screening is not as effective as many have assumed it to be. The message in this is that we do not know the true effect of any screening modality. Men should discuss prostate cancer screening with their physicians and decide for themselves how to proceed.
The post office is not promoting any particular prostate cancer treatment. The aim is solely to inform men that screening exists and that they should seek advice from their health care team.
EDWARD H. LIVINGSTON MD
and Perioperative Care
VA Greater Los Angeles
Health Care System