The PSA Fraud and the Prostate Cancer Business

Introduction

The PSA (Prostate-Specific Antigen) test became one of the most widely promoted methods for detecting prostate cancer in men worldwide. For years, it was marketed as a tool for prevention and early diagnosis. However, its very discoverer, Dr. Richard Ablin, denounced that PSA had been misused, turning into a massive medical and pharmaceutical business that caused more harm than good.

The Origin of PSA and Ablin’s Denunciations

Richard Ablin discovered PSA in 1970. From the beginning, he clarified that this marker should not be used as a screening test, but solely as a follow-up tool for patients already treated for prostate cancer.
Decades later, Ablin himself wrote a book where he called PSA a “public health disaster” when applied massively to healthy men. He also denounced that behind its use were pharmaceutical lobbying, the financial interests of some in urology, and the complacent approval of regulatory agencies.

Scientific Limitations of PSA

Lack of specificity: PSA can rise due to prostatitis, infections, or benign prostatic hyperplasia, not only cancer.
Arbitrary cutoff point: The classic threshold (4 ng/mL) lacks solid scientific foundation.
False positives and over-diagnosis: Up to 80% of men with elevated PSA do not have cancer.
No measure of aggressiveness: PSA does not distinguish between slow-growing tumors (which would never have caused symptoms) and truly aggressive ones.

Consequences for Patients

The indiscriminate use of PSA led to an excess of biopsies and, above all, to unnecessary treatments that left irreversible consequences for thousands of men:

Sexual impotence
Urinary incontinence
Anxiety and reduced quality of life

The Business Behind PSA

German physician Vincens Reich, in his book Fraude Oncológico Próstata (Oncological Fraud: Prostate), explains how PSA became a business tool rather than a true diagnostic method. He revisits Ablin’s warnings and describes how the oncology system profited from screening, biopsies, and subsequent treatments.

German writer Frank Wittig, multiple award-winner for his investigative work, also exposes in his books the problem of over-diagnosis and the lucrative excesses of the medical system, with prostate cancer at its core.

Evidence from International Studies

The European Randomized Study of Screening for Prostate Cancer (ERSPC) showed a 21% reduction in mortality at 13 years, but with 40% over-diagnosis.
The U.S. Preventive Services Task Force (USPSTF) in 2012 advised against widespread PSA screening in healthy men due to the unfavorable balance of benefits and harms.
More recent recommendations emphasize an individualized approach, assessing personal risk factors instead of applying the test indiscriminately.

Conclusion

The PSA test is useless as a mass detection tool, and its adoption as such was a historical mistake driven by economic interests. What matters is that every man understands:

PSA does not always indicate cancer.
It can lead to unnecessary treatments with severe side effects.

The legacy of Richard Ablin and of critical authors like Vincens Reich and Frank Wittig is a call for scientific and medical honesty, ensuring that patient health always comes before profit.

📚 Supporting References

Ablin, R. J. (2014). The Great Prostate Hoax. New York: Palgrave Macmillan.
New Scientist (2014). Prostate cancer test has been misused for money.
The Washington Post (2014). A case against prostate screening from a scientist who made it possible.
Reuters (2010). Prostate test a ‘public health disaster’: discoverer.
Reich, V. (2013). Fraude Oncológico Próstata.
Wittig, F. (2012–2018). Various publications on over-diagnosis and excesses of the medical system.
U.S. Preventive Services Task Force (USPSTF). Recommendations on prostate cancer screening.
Schröder, F. H. et al. (2014). Prostate-cancer mortality at 13 years of follow-up in the European Randomized Study of Screening for Prostate Cancer (ERSPC). New England Journal of Medicine.

📚 References with Links

Ablin, R. J. (2014). The Great Prostate Hoax. Palgrave Macmillan. 👉 View on Amazon
New Scientist (2014). Prostate cancer test has been misused for money. 👉 Read article
The Washington Post (2014). A case against prostate screening from a scientist who made it possible. 👉 Read article
Reuters (2010). Prostate test a ‘public health disaster’: discoverer. 👉 Read article
Reich, V. (2013). Fraude Oncológico Próstata. 👉 View on Amazon
Wittig, F. (2012–2018). Publications on over-diagnosis and medical excesses. 👉 Amazon profile
Ablin, R. J. 👉 Official Amazon Author Profile
U.S. Preventive Services Task Force (USPSTF). Prostate cancer screening recommendations. 👉 Official recommendations
Schröder, F. H. et al. (2014). Prostate-cancer mortality at 13 years… 👉 NEJM abstract