Section Three: Choose the most appropriate word or phrase, and note that the capitalization of letters can be ignored.
(AB) frenzied hunt (AC) the many ills (AD) biopsies (AE) heretics
(BC) liaison (BD) indolent (BE) approved (CD) a barrage of
(CE) flummery (DE) paregoric (ABC) hoax (ABD) poultice
(ABE) moderate (BCD) concurred with (BCE) tangential lines
Chances are that either you have prostate cancer or you know someone who does. One in three men aged between 40 to 60 has traces of it, with the risk rising as men grow older. Nearly 240,000 new cases were detected in America last year, more than any other type of cancer. Faced with such facts, any man would be forgiven for wanting to find the invader and_26_it—by any means necessary.
There is a raging debate, however, over whether that is wise. Some doctors insist that testing for a protein called prostate-specific antigen (PSA) helps detect prostate cancer early, making it far less deadly. Others contend that PSA screening
has prompted_27_needless treatment, calling into question whether the proteinprovides any useful information. Among those who believe the PSA test does more harm than good is Richard Ablin, the author of “The Great Prostate_28_”.
Despite some shortcomings, the PSA test became common practice in the 1990s, particularly in America. In 1986, the Food and Drug Administration_29_the test to monitor those already diagnosed with cancer. In 1994, it went further, authorizing the test to help detect cancer in men aged 50 and older. What followedwas a(n)_30_for tumors. In America there was mass screening in offices, in carparks and shopping malls. This was, in itself, harmless. PSA screening involves a simple blood test. The crucial question was what doctors and patients did once armed with the test’s imperfect information.
In the 1990s and early 2000s they did quite a lot. Doctors in America are
rewarded for doing more procedures, so they often recommend_31_to test for cancer. Almost 90 % of cancers detected by PSA screening led to further treatment such as radiation and prostatectomies. But it is unclear how many of these treated cancers were_32_, unlikely to spread beyond the prostate’s lining.
_33_treatment can cause incontinence and impotence, which often lead
people to seek yet further treatment, from penile implants to urinary cuffs. Attempts to avoid side effects have inspired new procedures, some of them of little value. Mr.Albin, and his co-author, Ronald Piana, are good at describing how_34_ ofAmerican health care—from doctors fears of malpractice suits to their fascination with new gizmos—conspired to encourage treatment. But this is a flawed book. Mr.Ablin races down _35_ of argument, making hyperbolic charges. Are theproponents of the PSA test really as bad as tobacco companies?
At the very least, though, he highlights the importance of the debate over whether PSA screening has helped or hurt patients. Deaths from prostate cancer dropped by 45% between 1993 and 2010, suggesting that the test may have helped. But the number of deaths began declining before PSA screening would have had much effect; screenings may also have identified cancers that were never going to become_36_, artificially raising survival figures.
Critics of PSA testing, once regarded as _37_, have gained credibility recently, as a result of two big new studies. An American trial reported that PSA screening brought a tiny increase in mortality, relative to a control group. A large European trial reported_38_benefit only in those aged 55-69; screening saved about one man for every 1,000 men tested. These studies helped convince a government panel in America to recommend in 2012 that no man be screened for his PSA levels.
The recommendation sparked a(n) _39_. The American Urological
Association declared itself to be “outraged”. Critics such as Dr. Catalona said that the trials were flawed. Now different doctors, faced with the same data, are drawing dramatically different conclusions. The result is a(n)_40_of practices both within America and outside it.