Public and Professional Reactions to U.S. Preventive Services Task Force Recommendations on PSA Screening
President Barack Obama recently solicited a Prostate Specific Antigen test to screen for prostate cancer during his yearly physical.
White House physician Dr. Jeffrey C. Kuhlman’s report, which was released October 31, said the test was performed after the President made an “informed patient request.”
The U.S. Preventive Services Task Force recently recommended against PSA-based screening for prostate cancer, which they said can do more harm than good. Yet the commander-in-chief felt it was important enough to ask for the test personally.
This begs the question: If the President of the United States, who has access to the Country’s best doctors and most current information, chooses the PSA test, why shouldn’t all men have the same choice?
Obama is fortunate to have the means and knowledge to ask his doctor for a PSA test, but if the USPSTF recommendation is adopted, millions of other men might not be as lucky. The test is not perfect, but it is the best current biomarker for prostate gland abnormalities.
We urge you to take action to preserve patients’ choice and save lives.
from American Association of Clinical Urologists
“The decision of no confidence on the PSA test by the U.S. government condemns tens of thousands of men to die this year and every year going forward if families are to believe the out-of-date evidence presented by the USPSTF. A decision on how best to test and treat for prostate cancer must be made between a man and his doctor. This decision is coming from a panel that doesn’t even include a urologist or medical oncologist.”
Skip Lockwood, CEO of ZERO –
The Project to End Prostate Cancer
PSA Test Provides Important Information
“We are concerned that the task force’s recommendations will ultimately do more harm than good to the many men at risk for prostate cancer, both here in the United States and around the world.
AUA’s (American Urological Association) current clinical recommendations support the use of the PSA test, and it is our feeling that, when interpreted appropriately, the PSA test provides important information in the diagnosis, pre-treatment staging, or risk assessment and monitoring of prostate cancer patients.
Until there is a better widespread test for this potentially devastating disease, the USPSTF — by disparaging the test — is doing a great disservice to the men worldwide who may benefit from the PSA test”
AUA President Sushil I. Lacy, MD.
Empowered to Make Decisions
“We know prostate cancer does not have symptoms in its early stages.
We all have a right to know if we have cancer and be empowered, well informed and active as we talk to our medical health care team to make decisions.
The PSA test has its flaws and limits, but it is the best test we have for now. It should continue to be used as researchers seek better and more specific tests.
Data exists that demonstrates a decrease in metastatic disease at time of diagnosis and a decline in mortality rates over the last decade.
The U.S. Preventive Services Task Force recommendation presents a series of potential problems such as retrenchment from Medicare and insurance coverage of PSA testing.”
Thomas Kirk, President and CEO,
Us TOO International
Continued Routine PSA Screening
We support continued routine PSA screening of informed patients until new AUA guidelines on PSA screening are issued. The Prostate Cancer Foundation supports a patient’s choice to have a PSA test, and strongly recommends intensified National Cancer Institute focus and research investment in better early detection tests of lethal prostate cancers.
The Prostate Cancer Foundation
No Urologists or Oncologists on Task Force
“The US Preventive Services Task Force is a group of primary care physicians, like pediatricians and ob/gyns, who never treat prostate cancer. They have simply misinterpreted the studies and have not seen men die of this fatal disease.”
Herbert Lepor, MD
New York University urologist
Wanting to Extend A Life
“At a recent meeting of The Clinical Society of Genitourinary Surgeons, I was privileged to hear a moving presentation by Jeffrey Zaslow about the best-selling book, The Last Lecture he cowrote with Dr. Randy Pausch who was dying of pancreatic cancer.
Mr. Zaslow shared anecdotes, video clips and his thoughts about this remarkable man who wanted to leave an imprint for his young children so they would know who their dad was.
I can’t help thinking how much Randy Pausch wanted to extend his life to be there for his children but had no chance.
Why the USPSTF would recommend denying men and women the right to learn their diagnosis of prostate or breast cancer—to detect it early—while still time to stop its path, is unfathomable.”
William J. Catalona, MD
A Disservice to Men
“Iam a former patient of Dr Catalona. I am 45 yrs old and was diagnosed with prostate cancer in April 2011 during a routine PSA test due to my taking testosterone supplements. The cancer was removed via nerve sparing open radical prostatectomy.
I do not see how the USPSTF can make a blanket recommendation without looking at the whole picture. They are doing a disservice to males with their statements.
My Gleason before surgery was 3+3=6 but 3+4=7 after. Dr Catalona got it out just in time as it was encroaching on the prostate’s membrane.
Would this task force have been willing to be the ones that would have had to tell my two teenage daughters and wife: ‘We are sorry but we were wrong. It should have been caught earlier.’
I think not.”
William M. Moore, Patient
40% Reduction in Prostate Cancer Deaths
“The USPSTF recommendation “ignores the fact there has been a 40% reduction in prostate cancer deaths over the past 10 years since PSA testing has been in place. The USPSTF ignores this information because it relies only on randomized trials and there are a number that have too short a follow-up and other serious deficiencies.”
Patrick Walsh, MD of Johns Hopkins
Prostate Cancer Survivor
“I am a prostate cancer survivor, thankfully for 20 years. My success story is about early detection.
I have a personal commitment to prostate cancer research. I have a large family to protect including many sons and grandsons. My grandfather died from prostate cancer because we didn¹t have the knowledge and possibility for early treatment that we have today. By the time he was diagnosed, it was too late.
It is sad and frustrating to me that the recommendations of the USPSTF would put us back to the situation of my grandfather, when it is avoidable.
A PSA test, a simple blood test, is about gathering information to make potentially life-saving decisions. Taking that opportunity away from men, especially in the face of respected studies that show a 40% decrease in prostate cancer deaths since the PSA era, has no rhyme or reason.
Men need to take an active role in getting out the message that prostate cancer screening is a test they need and want.”
Anthony Sansone, Sr.,
President of the Urological Research Foundation