Screening for Terrorists vs. Screening for Cancer

As the holiday travel season approaches, millions of American air passengers will become painfully reacquainted with Transportation Security Agency (TSA) screening measures. Passengers must submit to either medically unnecessary X-rays or intrusive gropings. Yet in the realm of health care the federal government has adopted a new policy of discouraging routine screening tests for many cancers. Although these two policies may seem superficially contradictory, they demonstrate an underlying common theme of the government seeking ever-greater control over our bodies and our freedom.

Screening travelers and screening patients share some common features. In both cases the goal is to sort through a large, mostly-normal population to identify the relatively few problem cases — either an undetected terrorist or a hidden cancer.

The TSA’s current approach of mass passenger screening has long angered many Americans. Frequent flyer Tabitha Hale described her own recent horror story at, “No, TSA, I will not lift my skirt for you.” Because the screenings are universal (lest the government be accused of “profiling”), the TSA routinely screens grandmothers and small children who pose no terrorist threat. Even worse, the TSA screeners are of dubious effectiveness. TSA screeners have failed to detect simulated bombs and real guns. The attempted hijacking of Northwest Airlines Flight 253 two years ago was thwarted not by the TSA but by alert passengers.

In contrast to mandatory screening for terrorists, the government is actively discouraging Americans from regular screening for common forms of cancer. The federal government’s U.S. Preventive Services Task Force (USPSTF) recently declared that men should not undergo routine screening for prostate cancer with the PSA blood test — currently considered part of prudent preventive health care for men over age 50 by many primary care physicians and the American Cancer Society. In 2009, the USPSTF similarly recommended restricting screening mammography to women over 50 (and only at 2 year intervals), despite the proven medical benefits of the current practice of screening women starting at age 40 at yearly intervals.