FORCE advocates for families facing hereditary breast and ovarian cancer in areas such as access to care, research funding, insurance, and privacy.
In May 2017, FORCE submitted comments on the U.S. Preventive Services Task Force (USPSTF) Draft Recommendation Statement and Evidence Review for Prostate Cancer Screening. The USPSTF is a panel of experts in prevention and evidence-based medicine which reviews of and develops recommendations on the effectiveness of a broad range of preventive services. Once finalized, these guidelines are utilized by health care providers to determine appropriate screening and care, and to inform insurance coverage decisions on specific preventive services.
The Affordable Care Act stipulates that any preventive service receiving a USPSTF rating of “A” or “B” must be covered by most health plans with no copay or cost-sharing for the patient. Consequently, these guidelines impact access to care for many members of the hereditary cancer community.
Current guidelines give a grade "D" to the use of prostate-specific antigen (PSA) testing to screen for prostate cancer. The new draft guidelines give a "C" to PSA testing. This means that the USPSTF recommends "selectively offering or providing this service to individual patients based on professional judgment and patient preferences." This is an improvement over the current prostate cancer screening guidelines released in May 2012, which recommended against the use of PSA testing for early detection of prostate cancer. We are concerned, however, that a grade "C" may negatively affect health care coverage for cancer screening of men with BRCA or other inherited genetic mutations which predispose them to prostate cancer.
It is important to differentiate between "average risk" men and those who may be at increased risk of cancer. FORCE suggested that the Task Force review the data, extend the evaluation and assign a grade “B” for PSA testing in high-risk men. See our submitted comments to learn more about our concerns and proposed revisions to the draft guidelines.
For more history on this issue, refer to information about the 2012 PSA Screening Guidelines posted on our website.