Another take on this discussion, is the issue of how health care works in the U.S. It's pretty clear that those without good health insurance are less likely to be screened or treated for prostate cancer. That is certainly not good, because some patients won't be diagnosed until their condition is difficult to treat. The flip side of this is that those who have good insurance ("gold plated" policies, or "cadillac plans") are much more likely to get screened and have a procedure to treat prostate cancer.
In this board, there has been a long debate about the merits of "definitive treatment" (surgery or radiation) vs. active survelliance. You might argue about where the line is between getting PCa removed, vs just watching it, but certainly there are people where PCa should be just watched, for example with lower grade disease in older people.
I'd argue that in the U.S., the line between surgery/radiation and AS gets shifted depending on the person's financial status. If you are poor, you run the risk of being undertreated. If you are rich, the risk is of being overtreated. Neither is a good thing. This is repeated for all kinds of medical treatment. That's what's wrong with American health care--it's bad to have a person's finances warp treatment decisions.