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PSA Screening Controversy: FAQ

What the USPSTF Prostate Cancer Screening Recommendations Mean for Men

What does the USPSTF recommendation against PSA screening mean?

The U.S. Preventive Services Task Force is an independent agency. It's made up of experts in preventive or family medicine who serve a four-year term on the panel.

Their recommendations are made for primary-care doctors. Many doctor groups that establish guidelines for patient care use the USPSTF recommendations. Agencies that fund health care -- Medicare and private insurers -- often set their policies based on USPSTF recommendations.

Health care reform -- the Affordable Care Act -- will require Medicare and insurance plans to cover preventive services recommended by the USPSTF. However, they may choose to cover preventive services not recommended by the USPSTF.

Will Medicare still cover PSA tests?

Because the USPSTF did not recommend PSA screening -- in fact, the panel recommended against it -- Medicare is not forced to pay for the screening tests.

That's up to the Department of Health and Human Services. And this week, after the USPSTF report came out, HHS Secretary Kathleen Sebelius said Medicare would continue to pay for PSA screening for men who want it.

Will private insurance still cover PSA tests?

No private insurer was required to cover PSA screening before the USPSTF recommendation.

Even under the Affordable Care Act, private insurers will not be required to cover PSA testing. Whether they will continue to cover it remains a question.

Should I stop getting PSA tests?

Maybe, and maybe not. But don't decide until you have a serious talk with your doctor.

The American Cancer Society's chief medical officer, Otis Brawley, is no fan of PSA screening. But he heartily endorses the ACS's advice to men: Discuss the benefits as well as the harms of PSA screening with your doctor, then decide for yourself.

Why are many doctors and prostate-cancer advocacy groups upset with the USPSTF recommendation against PSA screening?

After skin cancer, prostate cancer is the most diagnosed and most treated cancer in the U.S.

It's a big business. But WebMD discussed the USPSTF recommendation with doctors who strongly support PSA screening -- experts who are not in it for the money. They've seen men die painfully from prostate cancer. That kind of experience, psychologists say, influences opinion much more than statistics.

The same kind of process is at work in men treated for prostate cancer. These men strongly believe that the suffering they underwent saved their lives. Again, this kind of experience has a more powerful effect than the statistical knowledge that most of these men would never have died of their cancer.


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