Making Sure of Universal Coverage For Early Detection Prostate Cancer Screening

Categories: Fall 2009

Reform of the United States health care system is being debated in Congress and proposals are in discussion stages.

We want our readers to be aware of how the current health care reform proposals could affect access to early detection and treatment of prostate cancer.

If passed as now written, the public plan and the private insurance plans that are offered under the new Health Insurance Exchange will most likely not provide health coverage for or support access to prostate cancer early detection tests such as the prostate specific antigen (PSA) blood test and the digital rectal exam (DRE). Also, if this proposal did go into effect, it could influence the 36 states that now have coverage mandates to consider overturning their present laws.

As current proposals in the new Health Insurance plan are presently formulated, recommendations for coverage come from the Suggestions of Practice of the United States Preventive Services Task Force (USPSTF). It gives a grade of A, B, C & D for a service. A grade of A & B is given with a suggestion to offer or provide service. C is to provide services only if other considerations support the offering or if providing service is for an individual patient. D discourages use of the service.

USPSTF also gives an I-statement when it deems that current evidence is insufficient to assess the balance of benefits and harms of the service.

The Senate Affordable Health Choices Act in its draft form says a group health plan and a health insurance issuer need to cover services that have a rating of A or B.

The USPSTF has given the recommendations for prostate cancer screening as follows:

For men younger than 75: I

For men older than 75: D

In contrast, the American Urological Association recommends offering prostate cancer screening to men at age 40.

The National Comprehensive Cancer Center Network recommends, for men who have decided to have prostate cancer screening, an initial PSA at age 40 to determine risk level and an annual PSA and DRE thereafter.

Dr. Catalona and Dr. Patrick Walsh of John Hopkins strongly recommend annual PSA testing that begins at age 40. ( See articles available on the URF website: www.drcatalona.com)

Please take the time to read about this important health issue for men. Take a few moments to call, write and email your Congressional Representative and your Senators, urging them to revise this section of the Health Care Reform proposal and to include access to prostate cancer early detection tests in health care reform.

Your efforts can save lives.

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