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    USPSTF reform: PSA at forefront of Capitol Hill hearing


    Dr. Lynch was asked by Blackburn to explain the impact that the USPSTF decision has on patients.

    “About eight weeks ago, I had a patient with urologic symptoms come to me. He had prostate cancer that had spread throughout his skeleton. He asked me why he didn’t get that test. That was a difficult discussion,” Dr. Lynch recalled.

    Dr. Lynch described as “a good thing” the fact that the USPSTF is now considering an update of its PSA screening recommendation, but said it should happen more frequently than after 5 years. Dr. Bibbins-Domingo stressed the update review includes 15 sub-specialty experts in prostate cancer, including three urologists in a non-voting capacity.

    Dr. Lynch also observed that since the Blackburn bill was first introduced, “The USPSTF has improved its outreach to the public and stakeholders, but more needs to be done,” including publishing draft research plans and soliciting public comment in the Federal Register and providing adequate time for comment and review by external subject matter experts. Public comments should be made publicly available and a summary of comments received and recommendations of other federal agencies or organizations relating to the topic should be included.

    Dr. Bibbins-Domingo told committee members that research plans and comments are published on the agency’s “robust” website.

    More from Bob Gatty: MedPAC talks cost cutting as IPAB looms

    “Transparency is core to us,” she said. “If people don’t trust our recommendations, it is not good because we want people to use our recommendations. That is why we talk to as many groups as we can.”

    Opening the hearing, subcommittee chair Rep. Joseph R. Pitts (R-PA) noted that the Task Force’s PSA recommendation has limited access to preventive care, as did another USPSTF recommendation against routine annual mammogram screenings for women ages 40-49.

    “Such recommendations contradict clinical guidelines based on medical literature and experts in the field,” Pitts said. “The concerns are that these recommendations could undermine new models of care delivery.”

    There is a good chance that the Blackburn legislation will win approval of the GOP-controlled Congress, perhaps as part of the move early next year to repeal the Affordable Care Act, pledged by President-elect Trump. The ACA ties Task Force recommendations directly to insurance reimbursement requirements.

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


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