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    AUA pushes for USPSTF reform, coverage for PSA

    Organization fighting attempts to restrict access to screening

    Bob GattyBob Gatty

    Bob Gatty, a former congressional aide, covers news from Washington for Urology Times.

    WashingtonTwo years ago in May, the U.S. Preventive Services Task Force (USPSTF) recommended against PSA-based screening for prostate cancer, asserting that “many men are harmed as a result of prostate cancer screening and few, if any, benefit.”

    The Task Force said PSA tests should not be used regardless of risk and gave PSA-based screening a grade of “D.”

    The Task Force and its stance on prostate cancer screening were back in the news this spring, when a commissioner of the Medicare Payment Advisory Commission (MedPAC) questioned the benefit and cost of screening and the cost of resulting “unnecessary” treatments.

    In 2012, when the Task Force issued its recommendation, USPSTF co-chair Michael LeFevre, MD, made this comment: “Prostate cancer is a serious health problem that affects thousands of men and their families. But before getting a PSA test, all men deserve to know what the science tells us about PSA screening: There is a very small potential benefit and significant potential harms.”

    Dr. LeFevre went on to encourage clinicians “to consider this evidence and not screen their patients with a PSA test unless the individual being screened understands what is known about PSA screening and makes the personal decision that even a small possibility of benefit outweighs the known risk of harms.”

    That development, of course, set off alarms within the urology community and the following May the AUA issued its guidelines on prostate cancer screening, which state that, in men ages 55 to 69 years, the decision to undergo PSA screening involves weighing its benefits against potential harms. Shared decision making is recommended.

    AUA throws support behind USPSTF reform

    The recommendation prompted the AUA to support the USPSTF Transparency and Accountability Act, sponsored by Reps. Marsha Blackburn (R-TN) and John Barrow (D-GA). That measure, H.R. 2143, would require the USPSTF to:

    • publish research plans to guide its systematic review of evidence and new science relating to the effectiveness of preventive services
    • make available reports on such evidence and recommendations for public comment
    • codify the grading system used so it cannot be changed without an appropriate review
    • establish a preventive services stakeholders board to advise it on developing, updating, publishing, and disseminating evidence-based recommendations on the use of clinical preventive services.

    Continue to the next page for more.

    Bob Gatty
    Bob Gatty, a former congressional aide, covers news from Washington for Urology Times.


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