To the Editor The slogan “Less Is More” has an Orwellian ring to it, especially as government committees usurp the individualized decision making of clinicians. The recent editorial by Katz1 seems to imply that when a healthy 68-year-old man asks me to order a screening prostate-specific antigen (PSA) test for him, I should instead offer him an end-of-life discussion. I cannot apply results from a PSA study done on a Department of Veterans Affairs population, notorious for high rates of smoking and other bad habits, to my well-educated and health-conscious seniors who eat right, exercise, and stopped smoking in 1963. Because of their adherence to a heart-healthy lifestyle, my seniors have a longer life expectancy to protect, altering the balance of benefits and risks compared with other populations.
Keller DL. Why I Will Continue to Screen Prostate-Specific Antigen for Myself and Other Appropriate Men. JAMA Intern Med. 2014;174(1):164. doi:10.1001/jamainternmed.2013.11106