Nearly six months ago, U.S. Preventive Services Task Force (USPSTF) recommended healthy men no longer receive PSA tests as part of routine cancer screening. Ironically, this decision against routine PSA screening was made by a panel that does not include urologists or oncologists. The same task force tried unsuccessfully to eliminate mammograms for women ages 40-49 and recommended against teaching women to do breast self-exams. The panel made the PSA recommendation based on contradictory information from studies with serious design flaws. Based on USPSTF recommendations, the Government Accountability Office (GAO) singled out PSA tests as a screening that would require patient co-pays, potentially discouraging men to have testing that could identify cancer in its earliest, most curable stage.
The revised ERSPC data highlights the problems with the USPSTF process. Under the Affordable Care Act, this taxpayer-funded agency has been given great power to determine what screening tests must be provided. Despite this authority, the USPSTF does complies with neither the Federal Advisory Committee Act, (FACA) nor the Administrative Procedures Act (APA) which were enacted to ensure that those that ultimately work for American citizens conduct their business in an objective, transparent fashion. We as a country deserve to know who is making health policy decisions by what criteria, as well as if there is an inherent bias or potential conflict of interest that those with that decision-making power may have.
Ultimately, the decision on how to screen and treat prostate cancer should stay where it has always been: between patients and their doctors. This landmark research on the benefits of PSA screening is critical not only for men’s health, but also serves to illustrate the severe flaws in our existing process. Enactment of the USPSTF recommendations will cause the needless deaths of thousands of men, and not only must this recommendation be modified, but the entire process revised to ensure such missteps do not occur in the future.
Kapoor, M.D. is president of the Large Urology Group Practice Association, representing more than 1,800 urologists nationwide, as well as chairman and CEO of Integrated Medical Professionals, PLLC, the largest independent urology group practice in the United States.