Century City, CA (PRWEB) June 02, 2012
The California Prostate Cancer Coalition (CPCC) is strongly opposing the U.S. Preventive Services Task Force’s (USPSTF) final recommendation (May 22, 2012) against the use of prostate-specific antigen (PSA) testing for the early detection of prostate cancer. The PSA test, used in conjunction with a digital rectal examination (DRE), is the only method currently available to determine whether a man should proceed further to see whether or not he has prostate cancer.
The Task Force advises against the use of PSA testing in healthy men who “do not have symptoms that are highly suspicious for prostate cancer.” However, having symptoms usually indicates that the cancer is advanced and that the chance for cure is slim. CPCC condemns that recommendation as reckless. The PSA test has helped to dramatically lower the death rate from prostate cancer. “Knowledge is power, and early detection of potentially deadly prostate cancer saves lives and improves the quality of those lives,” said Merel Grey Nissenberg, Esq., President of CPCC and of the National Alliance of State Prostate Cancer Coalitions (NASPCC). “The Task Force recommendation means that physicians will stop offering the PSA test and men will stop requesting it. Next, insurers will stop paying for it.”
The California Prostate Cancer Coalition (CPCC) stands by its previous recommendation that beginning at age 40 (or beginning at age 35 for African-American men or men with a certain or indeterminate family history of prostate cancer) all men should be screened for prostate cancer. The PSA results can be the basis of informed discussions between a patient and his physician. By careful use of the PSA and other tests, an objectively informed man may be able to know his PSA and his risk for clinically significant disease without the downside of automatically undergoing treatment that in some cases may not be necessary. CPCC understands the need for more specific and sensitive biomarkers to determine when a man has potentially deadly prostate cancer, rather than insignificant disease.
The USPSTF placed heavy emphasis on the PLCO (Prostate, Lung, Colorectal and Ovarian) trial, whose prostate arm was flawed. Approximately half of the control arm received PSA testing one or more times as part of their routine care; and 15% of the screening arm patients were never screened, Additionally, African-American patients who have double the incidence of prostate cancer and more than double the death rate from it, only represented 4% of the study. Further, Dr. Gerald Andriole, Principal Investigator of the prostate arm of PLCO, stated last week during the PSA Town Hall at the AUA Meeting in Atlanta that the PLCO results do not reach a conclusion on, “screening vs. no screening.”
The USPSTF also ignored data available at CDC, NCI, NIH, the VA, CMS and other agencies. For example, the Centers for Disease Control (CDC) found that men with a family history of prostate cancer are 2-3 times more likely to develop the disease as described on the government websote http://www.cdc.gov/cancer/prostate/basic_info/risk_factors.htm. NCI modeling studies, “suggest that between 45%-70% of the mortality decline…can be attributed to that stage-shift induced by screening.” (Presentation at the 7th Annual African-American Prostate Cancer Disparity Summit, September 2011).
According to the California Department of Public Health, after the introduction of the PSA test prostate cancer mortality rates in California declined steadily by 36 percent between 1988 and 2009 among all racial/ethnic groups. This corresponds to similar rates for an increase in PSA screenings over the same period. Clearly, when detected and diagnosed early, prostate cancer has one of the highest overall survival rates of any cancer. That is especially true for the early detection of aggressive disease. The PSA test remains the best tool available today for early detection of potentially lethal disease.
The USPSTF decision-making process was reached without consultation with other federal agencies such as the National Cancer Institute and without consultation with medical specialists, who are actually excluded from membership. Patient advocacy organizations are also excluded. For all the reasons stated above, Merel Nissenberg President of The California Prostate Cancer Coalition believes the Task Force’s D recommendation is misguided and dangerous.
The California Prostate Cancer Coalition (CPCC) is a coalition of doctors, prostate cancer survivors (and families), nurses, support groups and others concerned about prostate cancer in California.
The National Alliance of State Prostate Cancer Coalitions (NASPCC) is an umbrella organization meant to encompass participation by all states - through their state prostate cancer coalitions, state prostate cancer task forces or state prostate cancer foundations
Contact: Merel G. Nissenberg (310) 525-3570, (619) 518-6465