Advocacy

FORCE advocates for families facing hereditary breast and ovarian cancer in areas such as access to care, research funding, insurance, and privacy.

Advocacy > Issues > Prostate Cancer Screening Guidelines Fall Short


Newsflash

11/1/2019 - FORCE, along with hundreds of medical and patient advocacy orgs, expressed support for a long-term reauthorization of PCORI.

10/28/2019 - We authored comments on the FDA's draft industry guidance on developing drugs for the treatment of male breast cancer.

9/27/2019 - FORCE and two dozen groups urged CMS to reconsider the 14-day Rule, which has created delays in patients receiving test results.

9/24/2019 - Signed onto a letter urging the President to waive out-of-pocket costs for seniors on Medicare who have precancerous polyps removed during a screening colonoscopy.

9/3/2019 - We joined over 50 orgs representing patients, advocates, caregivers, researchers, and physicians to support the appointment of Norman Sharpless as FDA Commissioner.

Prostate Cancer Screening Guidelines Fall Short

Screening & Prevention

Overview

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.

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