 You know in this country we have believed for a long time that early detection is the way to save lives We've thought that about breast cancer. We've thought it about prostate cancer. We think it about lung cancer We also think it about heart disease all kinds of diseases But is it really true? It may not be true when we come to prostate cancer that early detection is Saving lives so there are a number of ways we can define success The success of an early detection program or a screening program for prostate cancer You can define it at the population level How many men's lives did you save overall? You can define at the population level and ask the question Did you reduce the risk of dying from prostate cancer? But you also have to ask it at the individual level was a man's life improved or lengthened by getting Screened and getting treatment early treatment for prostate cancer and that's where we run into trouble with the prostate test You know there are some people who say That that men should get screened and if they have a high PSA they can then make the decision about whether or not They want to get a biopsy and then once they get the biopsy and let's say it shows that they have a very early cancer They can then make the decision about whether or not to get treated and it's true Theoretically you can make decisions all along the way But the reality is I think that it's very hard for a man or a woman who got say diagnosed with breast cancer But it would be very hard for a man diagnosed with very early prostate cancer to say You know what? I don't think I need to be treated in this country We tend to think treat it early go after it cut it out right away I think men just need to know what the score is they know they need to know what the trade-offs are between getting tested getting getting screened with a PSA test versus not getting screened and There are trade-offs on both sides and the way to change attitudes is to really really help people understand what those trade-offs are