The ad hoc experiment of PSA testing continues1 and men with lower urinary tract symptoms are at no greater risk of prostate cancer than those without symptoms, while overdiagnosis of prostate cancer is a major problem. In a recent chemoprevention trial, 24.4% of men in the placebo group had prostate cancer diagnosed over seven years yet only 6% could expect to develop clinical disease in their lifetime.2 Therefore, up to 75% of men diagnosed with prostate cancer by PSA screening may never develop clinical disease. They do, however, contribute significantly to radiotherapy waiting times for all cancer patients. The complication rate from treatment is significant and the demand on urological and radiotherapy services considerable. Without evidence of a reduction in prostate cancer mortality, the evidence of harm greatly outweighs the evidence of benefit.3 The ethical practice of medicine, and public health medicine in particular, requires sound leadership in the development and implementation of health policy. Dr Corwin’s patient appears to be let down as much by health policy decisions as by a shortage of resources.4