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USPSTF delays November meeting (and decision on prostate cancer screening)

Posted Oct 26 2010 12:00am

According to a story on today’s Wall Street Journal Health Blog , the U.S. Preventive Services Task Force (USPSTF) has canceled a meeting originally scheduled for November 1-2, when it was expected to re-vote on recommendations regarding the use of prostate cancer screening.

The Wall Street Journal has apparently received inside information suggesting that there may not be complete consensus within the USPSTF about its position on prostate cancer screening. However, The “New” Prostate Cancer InfoLink suspects that any lack of consensus is likely to be over relatively minor issues and that the USPSTF (when it issues its updated guidance) will still continue to state that there is no categorical evidence that screening for prostate cancer is associated with a reduction in overall mortality, leading to a “D” or an “I” rating for prostate cancer screening in selected groups of men. (An “I” rating means that current evidence is insufficient to assess the relative balance of benefits and harms of screening; a “D” rating means that USPSTF recommends against screening.)

Some among the prostate cancer advocacy community are concerned that a negative recommendation from the USPSTF will automatically result in lack of coverage for PSA testing because health care reform (through the Patient Protection and Affordable Care Act) requires that preventive services given an “A” or “B” recommendation by the USPSTF be fully covered by insurance. According to Ned Calonge, chairman of the USPSTF, however, insurance coverage is never an issue in USPSTF discussions. He also commented that full coverage of screening tests that do not receive an “A” or a “B” rating could still be mandated, saying, “There wasn’t a single person on the task force that felt that if a woman under 50 wanted to be screened” for breast cancer it shouldn’t be covered. (The USPSTF had recently recommended against screening for breast cancer in women of less than 50 years of age.)

The bottom line? The USPSTF will now be voting on this issue at a meeting in some time next March, and there will be a 4-week period for public comment after the USPSTF’s initial recommendation is announced.

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