Quest Fall09 : Page 1

Quest Wanting the Best in Health Care: Needed: Universal Access To Prostate Cancer Screening (prepa anting Wanting the Best in Health Care: Needed: Universal Access To Prostate Cancer Screening (prepared for QUESTreaders) R eform of the United States health care system is being debated in Congress and proposals are in discussion stages. We want our readers to be aware of how the current health care reform proposals could affect access to early detection and treatment of prostate cancer. If passed as now written, the public plan and the private insurance plans that are offered under the new Health Insurance Exchange will most likely not provide health coverage for or support access to prostate cancer early detection tests such as the prostate specific antigen (PSA) blood test and the digital rectal exam (DRE). Also, if this proposal did go into effect, it could influence the 36 states that now have coverage mandates to consider overturning their present laws. As current proposals in the new Health Insurance plan are presently for- mulated, recommendations for coverage Screening Makes Cure Possible “ Because prostate cancer arises silently and becomes incurable before causing symptoms, the only way to detect it early is through screening. Eliminating screening would also eliminate the possibility for early diagnosis and curative treatment. William J. Catalona, MD, Northwestern University Feinberg School of Medicine Chicago, Illinois ” come from the Suggestions of Practice of the United States Preventive Services Task Force (USPSTF). It gives a grade of A, B, C or D for a service. A grade of A & B is given with a suggestion to offer or provide service. C is to provide servic- es only if other considerations support the offering or if providing service is for an individual patient. D discourages use of the service. USPSTF also gives a grade of “I” If we protect ourselves when we're young, it just makes sense to do the same when we get older. when it deems that current evidence is insufficient to assess the balance of benefits and harms of the service. The Senate Affordable Health Choices Act in its draft form says a group health plan and a health insurance issuer need to cover services that have a rating of A or B. The USPSTF has given the recommendations for prostate cancer screening as follows: For men younger than 75: I For men older than 75: D In contrast, the American Urological Association recom- mends offering prostate cancer screening to men at age 40. The National Comprehensive Cancer Center network recommends, for men who have decided to have prostate cancer screening, an ini- tial PSA at age 40 to determine risk level and an annual PSA and DRE thereafter. Dr. Catalona and Dr. PatrickWalsh of John Hopkins strongly recommend annual PSA testing that begins at age 40. (See articles available on the URF website: www.drcatalona.com) All citizens should be afforded the same treatment as Senator Christopher Dodd who was recently diagnosed with early stage prostate cancer through a routine blood test (PSA) and biopsy and has elected to have surgery. Please take the time to read about this important health issue for men. Take a few moments to call, write and email your Congressional Representative and your Senators, urg- ing them to revise this section of the Health Care Reform proposal and to include access to prostate cancer early detection tests in health care reform. Your efforts can save lives. (Continued on bottom of page 8.)

Wanting the Best in Health Care

Needed: Universal Access To Prostate Cancer Screening<br /> (prepared for QUEST readers)<br /> <br /> Reform of the United States health care system is being debated in Congress and proposals are in discussion stages.<br /> <br /> We want our readers to be aware of how the current health care reform proposals could affect access to early detection and treatment of prostate cancer.<br /> <br /> If passed as now written, the public plan and the private insurance plans that are offered under the new Health Insurance Exchange will most likely not provide health coverage for or support access to prostate cancer early detection tests such as the prostate specific antigen (PSA) blood test and the digital rectal exam (DRE). Also, if this proposal did go into effect, it could influence the 36 states that now have coverage mandates to consider overturning their present laws.<br /> <br /> As current proposals in the new Health Insurance plan are presently formulated, recommendations for coverage come from the Suggestions of Practice of the United States Preventive Services Task Force (USPSTF). It gives a grade of A, B, C or D for a service. A grade of A & B is given with a suggestion to offer or provide service. C is to provide services only if other considerations support the offering or if providing service is for an individual patient. D discourages use of the service.<br /> <br /> USPSTF also gives a grade of “I” when it deems that current evidence is insufficient to assess the balance of benefits and harms of the service.<br /> <br /> The Senate Affordable Health Choices Act in its draft form says a group health plan and a health insurance issuer need to cover services that have a rating of A or B. <br /> <br /> The USPSTF has given the recommendations for prostate cancer screening as follows:<br /> <br /> For men younger than 75: I <br /> <br /> For men older than 75: D <br /> <br /> In contrast, the American Urological Association recommends offering prostate cancer screening to men at age 40.<br /> <br /> The National Comprehensive Cancer Center network recommends, for men who have decided to have prostate cancer screening, an initial PSA at age 40 to determine risk level and an annual PSA and DRE thereafter.<br /> <br /> Dr. Catalona and Dr. Patrick Walsh of John Hopkins strongly recommend annual PSA testing that begins at age 40. (See articles available on the URF website: www.drcatalona.com) <br /> <br /> All citizens should be afforded the same treatment as Senator Christopher Dodd who was recently diagnosed with early stage prostate cancer through a routine blood test (PSA) and biopsy and has elected to have surgery.<br /> <br /> Please take the time to read about this important health issue for men. Take a few moments to call, write and email your Congressional Representative and your Senators, urging them to revise this section of the Health Care Reform proposal and to include access to prostate cancer early detection tests in health care reform.<br /> <br /> Your efforts can save lives.<br /> <br /> PSA Testing Must Be Supported<br /> <br /> If PSA testing were excluded from the Health Care Reform Bill, those most at jeopardy would be people who cannot afford to pay for PSA testing out of their pocket. African-Americans, who have a 50% higher incidence rate and 200% higher death rate from prostate cancer would be particularly affected.<br /> <br /> William J. Catalona, MD<br /> <br /> USPSTF’s Misguided Recommendation <br /> <br /> The USPSTF’s misguided recommendation (and the resulting media coverage) could give reluctant men of any age an excuse to postpone or forgo screening, which would undoubtedly result in delays in potentially lifesaving treatment, with possible unnecessary deaths.<br /> <br /> William J. Catalona, MD, Northwestern University<br /> Feinberg School of Medicine Chicago, Illinois

Next Page


Publication List
 
Loading