On Monday May 21st, the United States Preventive Services Task Force (USPSTF) issued its final recommendation to downgrade the prostate-specific antigen (PSA) test to a "D" rating. Congressmen Joe Baca (D-CA) and Jon Runyan (R-NJ), Co-Chairs of the Prostate Cancer Task Force, along with Congressman Dan Burton (R-IN) and Dennis Ross (R-FL), believe the PSA test, credited with saving thousands of men's lives, should remain a vital safeguard for men's health.
The USPSTF's recommendation could have disastrous consequences for early detection of prostate cancer, which is the leading cancer for men in the U.S. This change could potentially have negative effects on the three highest at-risk groups for developing prostate cancer: African Americans, men with a family history of prostate cancer, and veterans exposed to Agent Orange.
The current statistics state that one in five African American men will be diagnosed with prostate cancer and that both men with a family history of prostate cancer and soldiers exposed to Agent Orange, especially Vietnam Veterans, face a two times greater risk of developing prostate cancer.
The USPSTF believes PSA screenings should only be used when prostate cancer symptoms are apparent. But according to a number of prostate cancer researchers, when symptoms are obvious, the disease has already reached an aggressive state, ultimately lowering the rate of survival. A "D" rating also may justify non-coverage of PSA testing by many payers, and may also discourage men and doctors from talking about early screening.
"I am concerned that the USPSTF has made an error downgrading the PSA test and recommending against the use of the PSA test," said Congressman Runyan. "A majority of physicians believe this test is important in helping catch early-stage prostate cancer and is credited with saving the lives of thousands of men across our country. Downgrading the PSA test to a "D" could cause Medicare, Medicaid, and private insurers to choose not to cover the PSA test and could take away an important medical choice of tens of thousands of men. I would encourage the Secretary of Health and Human Services to re-examine the USPSTF's recommendation."
"The PSA test is responsible for saving the lives of thousands of men across the United States," said Congressman Joe Baca. "I fear that downgrading this vital preventive service is a significant mistake that may jeopardize the health and safety of American men. I urge the Department of Health and Human Services to stop this misguided policy change, and instead work to place greater emphasis on the education and awareness necessary for early detection of prostate cancer."
"Prostate cancer is the second deadliest cancer affecting men," said Congressman Ross. When caught early, prostate cancer is easier to treat and the chances of survival are much higher than if it metastasizes. None of the tests for early detection are one-hundred percent accurate. The USPSTF's rationale for the downgrade stems from a risk of false-positive results, which can lead to an "over diagnosis" of prostate cancer. While the shortfalls of the test are recognized, it is still the best tool for early detection."
"I am deeply dismayed by the USPSTF's decision against annual P.S.A. tests for prostate cancer," stated Congressman Burton. "While I recognize that there are limitations to the P.S.A test, it still remains one of the best tools available to assess risk for the disease. The consequences of failing to cover the test are dire. Cost will now take on an outsized role in the decision about whether a man should take the P.S.A. test, increasing the likelihood that his doctor will be denied the full complement of information needed to make the best possible decision for the patient's individual circumstances. I firmly believe that the decision to use the P.S.A. test should be left in the hands of the doctor and the patient, not the USPSTF. In addition, as we struggle to reshape our health care system to focus more on prevention and early detection of diseases, this kind of recommendation does far more harm than good."
Congressmen Baca, Burton, Ross, and Runyan will continue to work to promote and encourage men to talk to their doctors about the PSA test.