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 and develops recommendations on the effectiveness of a broad range of preventive services. 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.
Unfortunately, the guidelines now give a grade "C" to the use of prostate-specific antigen (PSA) testing to screen for prostate cancer. This means that the USPSTF recommends "selectively offering or providing this service to individual patients based on professional judgment and patient preferences." The is an improvement as the prior guidelines, published in May 2012, gave a "D" to PSA testing and recommended against its use in 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 high-risk men who encounter issues with insurance coverage of PSA testing, we have created a sample appeal letter which shows that this screening is medically necessary.
For more history on this issue, refer to information about the 2012 PSA Screening Guidelines posted on our website.