On April 11, 2017, the United States Preventive Services Task Force (USPSTF) issued an updated draft recommendation on Screening for Prostate Cancer. The following statement may be attributed to Neal D. Shore, MD, FACS, president of LUGPA:
The updated recommendation changes the grade for PSA-based screening from “D” to “C” for men aged 55-69 years. As a result, the USPSTF now recommends that clinicians discuss with men aged 55-69 what the potential benefits and harms of prostate (PSA) screening entail. For men aged 70 years and older, the USPSTF maintained its “D” recommendation that 70 and older should not be screened for prostate cancer.
LUGPA strongly opposed the Grade “D” rating issued by the USPSTF in 2012, and believes that the recent increase in newly diagnosed advanced prostate cancer with more aggressive biology is due in part to those misguided recommendations. Regrettably, patients diagnosed with these higher-grade and higher- stage cancers have less likelihood for cure. While the change in recommendation from “D” to “C” softens the recommendation regarding PSA screening with respect to men aged 55-69, LUGPA is still concerned regarding the USPSTF’s continued use of arbitrary age cutoffs in issuing its recommendations, both for younger and older men.
In its current draft recommendation, USPSTF acknowledged the well-established data regarding increased risks of prostate cancer in high-risk populations (African-American men, men with a family history of – prostate cancer, and men with other hereditary malignancies). While LUGPA is gratified by this belated recognition, LUGPA believes that the USPSTF did not adequately address the needs of these high-risk groups in neither younger men nor for healthy male populations over 70; both groups that could benefit from early detection of prostate cancer.
LUGPA has always recommended that patient physician shared decision making requires thoughtful and clear communication with men of all ages who might be at risk for prostate cancer diagnosis. For those patients newly diagnosed with prostate cancer, LUGPA believes a full discussion of all treatment options (including active surveillance and approved interventions) is required.
LUGPA has been working diligently to reform the USPSTF process, in order to increase transparency and promote greater expert input. These efforts are underscored by the recent USPSTF draft decision, which demonstrates the continued need to enact The U.S. Preventive Services Task Force Accountability and Transparency Act (H.R. 539), which would require the USPSTF to formally consult with stakeholders, including specialists and patient groups, in the development of new recommendation.
LUGPA will continue its review of the USPSTF draft recommendations, and will work collectively with all experts in the field and will issue comments reflecting LUGPA’s commitment to the rights of individual men to access appropriate screening services.
LUGPA is a trade Association that represents independent urology group practices in the U.S., with more than 2,200 physicians who make up more than 25 percent of the nation’s practicing urologists, and provide more than 30 percent of the total urologic care in the U.S. The association is committed to providing the best resources and information for its member practices through advocacy, research, data collection and benchmarking efforts. LUGPA advocates for independent urology practices by promoting quality clinical outcomes, fostering new opportunities and improving advocacy in the legislative and regulatory arenas. For more information, visit lugpa.org.