I’m married to someone running various prostate cancer studies in the UK. I hear the arguments against screening a lot and the issue really blew up recently in the news here.
The thing is, when researchers talk about “worse outcomes” they’re often comparing survival (or rather lack of) against terrible side-effects.
What this fails entirely to capture is that doing something to increase your odds of survival, damn the consequences, is an individual choice. It shouldn’t be up to a health economist to make that judgement.