CMS issues inappropriate proposal to “discourage the use of PSA-based screening”


Apparently our friends at the Centers for Medicare and Medicaid Services (CMS) have misunderstood the details of the D recommendation about PSA screening for prostate cancer issued by the U.S. Preventive Services Task Force (USPSTF) in 2012, and are now seeking input on a proposed mechanism ““to discourage the use of PSA-based screening in the general population of men,” on the grounds that, “A lower rate on this measure indicates better performance.”

The problem is that the actual proposal goes way beyond “discouraging PSA screening” because it would actually discourage any use of the PSA test in an otherwise healthy male. Even the USPSTF never went anywhere close to such a recommendation! The recommendation as written is, at best, strange and ill-advised — even if one thinks that mass, population-wide, PSA-based screening for risk of prostate cancer is not one of the world’s greatest ideas.

Prostate Cancer International is currently preparing comment on this distinctly strange and ill-advised proposal. We are sharing our proposed comments with other advocacy organizations, including the members of PCPC3, the Men’s Health Network, and others. We are aware that the American Urology Association is also developing and will be submitting comment. Other organizations may also be doing so. We will submit comment, as required, some time before 11:59 p.m. on November 20, 2015.

Those who are interested in so doing can review the precise proposal issued on behalf of CMS and the precise mechanism for submission of comment by clicking on the two links in this sentence. We encourage such comment from a wide spectrum of the prostate cancer community.

Prostate Cancer International will upload it’s comments to CMS on this web site as soon as we have finalized those comments.

4 Responses

  1. Prostate cancer is on the rise, and we’re even seeing guys in their 40s inflicted with this, the worst disease a male can get.

    PSA is an extremely important diagnostic tool. My own initial 744 PSA was spot on, indicating accurately the highly advanced nature of my own advanced, metastatic prostate cancer, which had metastasized to all of my pelvic lymph glands as well as the spine and sacrum.

    The prostate tumor was so large that it was invading the urinary bladder, partially blocking both ureters and bladder outlet and against the rectum wall. Surgery wasn’t possible, and my urologist got me on the ADT just in time to prevent complete ureter blockage and possible kidney failure or damage.

    Now my PSA is rising again, and the urinary symptoms and pain increasing, which clearly indicates that the cancer is growing again, having been slowed for 3 years by ADT. PSA is a necessity, and only an idiot cannot see the value of PSA testing.

    Charles ERIC Winter

  2. Reblogged this on Dan's Journey through Prostate Cancer and commented:
    Now the Centers for Medicare and Medicaid Services (CMS) are pushing to discourage PSA testing based on the USPSTF recommendations. You can provide input (by 20 November) by submitting a comment to CMS.

  3. Good for you!

  4. “Comment—PSA Screening” for the “Non-Recommended PSA-Based Screening” measure

    This proposal is overly complicated, aimed at doctors rather than patients, and is narrowly focused on one element of prostate health. It is an attempt to control doctors rather than allowing patients to make informed decisions based on their individual conditions and screening and treatment alternatives associated with screening or all treatment alternatives.

    As a patient it must be patient choice to decide on screening or not and when screening should occur based on the patient overall health — a holistic view of patient health and prostate conditions, including the results of digital rectal exam (DRE) of the prostate, patient family history with respect to prostate cancer, patient expected lifespan (this data exists on SSA website) and patient desire for a healthy quality of life for remaining time on this earth. If CMS feels the need to improve quality of outcomes, focus on the creation of a patient-focused decision matrix that could be made available to patients by their doctor to enable an informed decision about what to do, if anything based on all factors important to each individual patient.

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