-
Type:
Hosp Inpt eCQMs - Hospital Inpatient eCQMs
-
Resolution: Unresolved
-
Priority:
Minor
-
Component/s: None
-
None
-
Craig Pynn
-
925-708-7491
-
Comment - PSA Screening
I was diagnosed with advanced prostate cancer in 2009.
While the statistical evidence—itself subject to dispute—may support the current USPSTF recommendation to eliminate PSA screening, emerging evidence indicates that the “no screening” regime will lead inexorably to the pre-PSA era of rising initial diagnoses of advanced prostate cancer.
At the Genitourinary Cancers Symposium held in February 2015 in Orlando, Florida, Dr. Timothy Schultheiss of City of Hope Hospital, Duarte California, stated, “Our study was the first to measure the changes in prostate cancer presentation in the period following the USPSTF prostate-specific antigen (PSA) screening recommendations.”
(http://www.practiceupdate.com/news/6914/32/1)
Dr. Schultheiss calculated that based on 233,000 new prostate cancer cases predicted for 2014 by the National Cancer Institute, 14,000 more men would be diagnosed with high risk prostate cancer than were diagnosed in 2011. Worse, “the investigators predicted that at least 1400 additional men might die from prostate cancer each year” than would have been the case before PSA screening was declared unnecessary and even harmful.
The USPSTF recommendation that ignorance about the state of a man's prostate is preferable to knowing even a baseline PSA has already resulted in more men being diagnosed with advanced prostate cancer and more men dying. This trend will doubtless continue unless the USPSTF rescinds or modifies its position on screening.
I feel the USPSTF recommendation is this not only egregious public health policy, but it also implies strongly that men are just too stupid and their doctors just too greedy that they would do anything other than proceed without hesitation to biopsies and treatment based on the results of a single PSA test. Apparently, it has not occurred to the USPSTF to consider that a raised PSA level might actually be the beginning of intelligent conversation between doctor and patient--long before biopsies and treatment.
That the CMA would then use the USPSTF mandate as the basis to levy financial penalties on doctors who have the temerity to offer their patient a PSA test is beyond egregious, bordering on requiring doctors to commit malpractice.
I strongly recommend that the USPSTF adopt the far more intelligent and compassionate policy on screening that has been adopted by the American Urological Association.