Jeremy Clarkson recently went public about surviving prostate cancer, and he offered some blunt advice: if your doctor won't test you, lie to get the test. That clip kicked a hornet's nest.
I'm genuinely stoked that Jeremy is fine. But his point about lying to your doctor doesn't only apply to prostate cancer — it applies to all cancer screening. And the conclusion I've reached is probably going to get me into a bit of trouble.
Because here's the thing: I've personally gone against medical advice and had a full-body MRI to screen for cancer, even though the American College of Radiology explicitly recommends against it [1]. So why would they recommend against it? Surely more data is better, and finding problems before symptoms appear gives the best chance of successful treatment? What I want to do is put the real numbers on the table and show you why the medical community is hesitant, so that you can make a more informed choice about your own health.
A quick note if you're new here. I'm Brad Stanfield, a family medicine doctor, and my goal on this channel is to explain the science of preventative care. But even though I'm a physician, I'm not your physician — so before you make any changes to your health, please discuss them with your own doctor first.
Table of Contents
- Why a Doctor Might Hesitate About Screening
- Does the PSA Test Actually Save Lives?
- What Saying "Yes" Really Costs
- Your Decision, Not the Doctor's
- The Screening Programs We Can Learn From
- Where Cancer Screening Is Heading
- The Bottom Line
- References
Why a Doctor Might Hesitate About Screening
The reason a doctor may hesitate about cancer screening isn't about cost, and it isn't about being cruel. It's that a test is never just a test. What we're really concerned about is the chain of events that a positive result can set off. But this does need some nuance, so let me explain with a couple of examples.
If we look at the US Preventive Services Task Force, in 2018 they issued guidance on prostate cancer screening. They concluded that for men aged between 55 and 69, the decision to undergo periodic PSA-based screening should be an individual one [2]. In other words, not a blanket rule.
But why shouldn't everyone just get tested?
Does the PSA Test Actually Save Lives?
That's exactly what a large study published in 2024 set out to answer, with a 15-year follow-up period. One group was screened with the PSA blood test, and the other wasn't. The group that got screened died from prostate cancer at a rate of 0.69%, versus 0.78% in the group that didn't get screened, over that 15-year window [3].
So screening works — it does lower the death rate. If that were the whole story, the article would stop right here, Jeremy Clarkson would be completely right, and I'd be telling you to go and get a PSA test. But we can't stop here, because I haven't shown you what actually getting that test costs.
What Saying "Yes" Really Costs
This is the part that Jeremy Clarkson didn't mention, and it starts with a fact. Most men who have prostate cancer never die from it. They die with it — and they never knew it was there. This was shown in a 2015 autopsy study that looked at men who had died and examined how many actually had prostate cancer. The startling finding: from the age of 79 and above, 59% of the men had prostate cancer, but it hadn't harmed them [4]. If those men had gone ahead with a procedure on their prostate, they'd have had no benefit — only harm.
So here's the critical point. If you go looking hard enough, you'll find cancer in a huge fraction of the population. The best estimate is that around 40% of the cancers screening finds would never have hurt anyone. But once you've found it, it starts a chain reaction you can't easily get off — beginning with biopsies, which in the prostate example means needles into the gland.
Now here's the trial that should be on every man's radar. Men with localised prostate cancer were split three ways: some went on to have surgery, some radiotherapy, and some just careful monitoring. Over the 15-year follow-up, men had the same roughly 2.7% chance of dying from prostate cancer whether they chose surgery, radiotherapy, or active monitoring, with no significant difference between the groups [5].
So there's the same survival — but not necessarily the same quality of life, because of what the treatment can do to you. For example, in a 2016 study, six months after surgery the share of men with erections firm enough for intercourse had fallen to just 12%, and 46% were using absorbent pads for incontinence [6].
This is precisely the point. It's not a clean yes and it's not a clean no. It's a genuine, agonising call about whether to go ahead with prostate cancer screening, and it depends on how you would weigh a small chance of living a little longer against a real chance of treatment harm.
Your Decision, Not the Doctor's
And this is another critical point: it is your decision, not the doctor's, to make. That's very important. We want to be practising patient-centred care. Gone are the days of doctors simply telling patients what to do — gone are the days of paternalism. This is exactly why the prostate cancer guidelines are written the way they are: the decision to screen should be an individual one, as in you, the individual, should be making the decision.
So this is where I agree with Jeremy. If a doctor is going against your wishes, please seek help, and discuss it with your friends and family members. And this is where I might get into a bit of trouble: there is nothing wrong with seeking a second opinion. That's especially true now, when I think we're on the cusp of cancer screening changing permanently.
The Screening Programs We Can Learn From
Some cancer screening programs are proven to save lives — bowel cancer screening, mammograms for breast cancer, cervical cancer smears, and lung cancer screening in select populations. The more interesting discussion is what to do about the other types of screening where the answer isn't clear-cut, like the prostate example. There are three concrete cases we can learn from.
Take thyroid cancer. This really kicked off in South Korea, where in the early 2000s they introduced a thyroid cancer screening program using ultrasounds. They found that a huge number of people had thyroid cancer, and they started operating. But during the follow-up, while diagnoses rose 15-fold, death rates from thyroid cancer stayed flat [7]. People were having operations and interventions, but there was no survival benefit.
It's the same story with ovarian cancer. A large UK trial combined blood tests and ultrasounds in one group and compared it against usual care — and after a median of more than 16 years of follow-up, there was no significant difference in death rates [11]. So screening on its own doesn't automatically mean better health outcomes. What we need to do instead is learn from these examples.
Where Cancer Screening Is Heading
It might be that cancer screening needs to move more towards a time-based series. Instead of rushing in with surgeries and biopsies, we sit back and regularly rescan with ultrasounds and MRIs — especially as scan costs keep coming down as the technology improves.
But even this strategy has a problem. In 2026, a meta-analysis of over 9,000 asymptomatic people found that whole-body MRI scans detected cancer in 1.57%, or about one or two in 100 — but there are still no long-term outcomes showing whether this actually saves lives [8]. 1.57% isn't a bad hit rate, but the problem isn't the finding rate. It's that no one has ever shown these scans make you live longer, and the cascade behind every finding is the same one we just walked through. We have to be careful that these extra scans, if something is found, don't automatically trigger that cascade of biopsies and surgeries.
Because of this lack of data, I don't think any doctor should be recommending full-body MRIs — we simply lack the mortality data. But equally, this information should not be withheld, and I don't think doctors should be a barrier if a fully informed person wants to go ahead. If a patient knows the risks of moving ahead with a scan like this, I would personally support them along their health journey. It's my job to meet a patient where they are. At the same time, we need to make sure there are no conflicts of interest. What I've heard is that some doctors have affiliate schemes with full-body MRI clinics — where referring a patient earns the doctor a financial kickback. That is not acceptable and should never happen, because it introduces exactly the kind of conflict of interest we should be avoiding.
Before moving on, I want to share something verbatim, because it's really important. Some radiologists have proposed an informed-consent statement for anyone in the general population considering a whole-body MRI [9]. It reads:
No medical guideline recommends that you undergo this test. There is a three in 10 chance that we find something that creates uncertainty for you, which could result in anxiety, sleeplessness, financial strain, life disruption, more imaging, invasive procedures, or possibly surgery. Although cancer will be identified in one or two out of 100 people, finding cancer with this test is unlikely to help you because most types will be low risk or already advanced. There are no studies showing that undergoing this test will improve the quality or the length of your life. Based on what we know, if you undergo this test, you are more likely to be harmed than helped, due to complications from efforts to diagnose and treat what we find and the low likelihood we find something that can improve the quality or length of your life. On average, any apparent benefit is likely illusory, even for many cancers. This test does not replace effective but often underused screening tests, such as mammograms or colonoscopies. The cost of this test is borne by you out of pocket, and future care and costs will be your responsibility.
People have the right to make their own informed choices about their health. If you are considering buying this test, our advice is buyer beware. You might lose more than just your money.
There are also cancer blood tests, such as the Galleri test. These look at specific methylation markers, with the hope that a single test could screen for and diagnose multiple cancers at once. This was recently trialled by the NHS in England — but in 2026, the result came through, and the trial failed to meet its primary endpoint [10]. To be clear, I'm not saying you shouldn't have this test. I'm saying that's what the data currently shows, and it's up to you what you decide for your own health.
Now for something a bit more exciting. One company is trying to make a whole-body scan that costs almost nothing and takes about a minute — the AI imaging company Midjourney. It's essentially a full-body ultrasound, and Midjourney claims this "Ultrasonic CT" can aim for whole-body imaging that's in many ways superior to even MRI machines, with a scan taking as little as 60 seconds — no radiation, no powerful magnetic fields, just sound and water. Now, that's their pitch, and I want to be honest with you: this is an early prototype, it isn't approved, and radiologists have already pushed back, because sound waves can't see through bone and air the way an MRI can. Maybe there's some AI wizardry that Midjourney is doing, but that's well outside my area of expertise to form an informed opinion. "Better than MRI" is a big claim that still has to be proven — but the direction is unmistakable: scanning overall is getting cheaper and faster.
The Bottom Line
So where does that leave Jeremy Clarkson and his advice to lie to doctors? To me, the honest answer isn't to screen everything, and it isn't to just trust the doctor's no. It's that a doctor's job is to hand you the real numbers — the good and the frightening — and then to walk beside you with whatever you choose. The final decision should be made by you.
And that's exactly what I decided to do for my own health. I understand the risk that if something were found on my MRI, it might trigger a whole batch of tests, biopsies, and surgeries. But I know that for me, I'd want the time-series approach — where even if something looked alarming, I'd wait to see what happened on the follow-up scan before rushing in.
References
2. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/prostate-cancer-screening
3. https://doi.org/10.1001/jama.2024.4011
4. https://doi.org/10.1002/ijc.29538
5. https://doi.org/10.1056/NEJMoa2214122
6. https://doi.org/10.1056/NEJMoa1606221
7. https://doi.org/10.1056/NEJMp1409841
8. https://doi.org/10.1007/s00330-025-11976-5
9. https://doi.org/10.1001/jama.2026.5888
