Has Sebelius overruled USPSTF recommendation on PSA screening?


According to an announcement on the web site of Congressmen Dennis Kucinich late yesterday, HHS Secretary Kathleen Sebelius has agreed to overule the draft recommendation issued by the U.S. Preventive Services Task Force (USPSTF) related to the use of PSA testing as a means to detect prostate cancer.

The exact implications of this are not clear, and there is no statement available at this time on the HHS web site. The “New” Prostate Cancer InfoLink will be “watching this space” with care.

9 Responses

  1. It is obvious that one has to be careful in interpreting this release. The actual quote is “Secretary Kathleen Sibelius agreed to overrule the recommendation”. There is no actual recommendation yet, just a draft. Not sure how you can overrule a draft, rather than the final version.

    Either way, it seems to indicate that Secretary Sibelius may handle the USPSTF recommendation for prostate cancer screening similarly to how she handled a USPSTF recommendation for breast cancer screening just a few years ago.

  2. Now why would she do that? Because she doesn’t like the fact that the studies don’t support an A or B recommendation or she thinks that there is enough data for something other than C or D? Or maybe because of political reasons. This is getting way out of hand and I am finding the whole mess to be extremely unscientific and upsetting.

  3. I’m not sure the government should provide medical rulings about how people and doctors deal with each other (see abortion, right to die, …). The thing needed here is higher quality information for people who are diagnosed — what they have and how to deal with it as well as possible. I hope the government works with science to define effective clinical studies and research in this area. The people who need treatment have some reasonably good options right now

  4. It is complex; however, the evidence shows screening reduces the death rate and reduced the risk of distant prostate cancer.

  5. HOORAY! Another million men unnecessarily in diapers! Another million men impotent, depressed, and unable to connect at the basic of level of human connectedness who didn’t really have to suffer such losses! What a big win for the power of political advocacy over science and for the AUA, Big Pharma, and the producers of adult “hygiene” products’ market development teams!

    Great job, let’s see if Kimberly-Clark and Pfizer stocks are up on Monday a.m. What a successful strategy! Let’s run all our economic stimulus programs by scaring people into unnecessarily presenting themselves for intentional maiming and ensuring they become permanent customers who have to buy services and medical interventions for the 20, 30 or even 40 remaining years of their lives in a (most likely vain) attempt to not chronically soil themselves and to regain the ability to physically and emotionally connect with the people they love most in the world. Just think what men will be willing to spend to try and solve those problems! HOORAY!!!

    A million men! What a huge market to capture (and, more importantly, what a huge market to lose;)! Hooray! HOORAY!!!

    Just out of curiosity, of all the prostate cancers diagnosed by biopsy in a given year (say the last year for which data are available), what number and percent fall into the category of low volume, Gleason 6? If the men with this diagnosis were (at least temporarily — until it seemed reasonably apparent progression was occurring) taken out of the pool of new “cancer” cases, what would the rate of prostate cancer diagnosis look like? And what would the rate of “curable” prostate cancer cases look like?

    It’s pretty obvious why those who sell services and products to “cancer” patients have a vested interest in defining those men as having cancer. But I’m not sure we spend enough time thinking through what’s in it for the advocacy community. The more people diagnosed with a disease, the bigger the social problem they get to carve out a role in solving. The more people diagnosed, treated, and “cured,” the happier story there is to tout from which to raise donations, interest, and concern. The more people defined as having a “cancer” who are unlikely to actually die from it, the easier it is to show that we’re “winning” in the fight against prostate “cancer.” But most importantly (and strategically successful), the more “curable” “cancers” they have to lift up, the less time they have to spend answering questions about the dearth of progress in helping those truly afflicted with intransigent, aggressive prostate cancers that are authentically hard to understand and control.

    The question of ethics becomes: How many men are the “pro-diagnosis with disregard for over-treatment” proponents willing to sacrifice to the destructive, life-altering effects of treatment in order to have a significant enough of a population with “cancer” to capture the fears, hearts, and minds of policymakers, media, and the general public in order to fund the research into the needs of those truly afflicted with life-threatening disease? Because that’s the game we’re playing here. … And that’s the the game the USPSTF is responding to, which is the only real HOORAY! to be celebrated in this debate.

    The answer is apparently 1,000,000 to date and, at minimum, 1,000,000 more based on Sebilius’ willingness to suspend disbelief, ignore the evidence, and cave to the puritanical and/or profit-seeking.

    HOORAY for political expediency! HOORAY for the power of fear-mongering over science! HOORAY for growing the brotherhood of prostate cancer “survivors” at any and all costs to the lives of those unnecessarily (and too often unwittingly) trapped in the net of profit-seeking, intellectual mendacity, and/or an evangelical-like zeal for perpetuating the mental and emotional rationalizations needed to survive one’s own treatment outcomes. HOORAY!!!

  6. How can anyone applaud this, when one person has overruled a task force made up of scientists, physicians, and technicians. It sounds way too political for my liking. I prefer science to politics 10:1.

  7. And if she does, it will be the second time in less than 2 months. Utterly shameful.

  8. Scientists and their recommendations got us into the current state. The fact that people won’t simply change their practices abruptly based on a new recommended guideline is to be expected.

    People don’t take PSA tests in a vacuum and doctor’s are trained to treat from the information based on the earlier recommendations. I think that it is best for all to take a deep breath and take time to understand and react to the information. Things will change for the better, but it will take time.

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