The Akron Legal News

Reconsideration of screening for prostate cancer urged by lawmakers

TIFFANY L. PARKS
Special to the Legal News
Published: January 17, 2014

A measure that calls on Congress to seek the withdrawal of the U.S. Preventative Services Task Force recommendation to not utilize prostate-specific antigen-based screening for prostate cancer for men in all age groups is scheduled for a second hearing before the state House Health and Aging committee Wednesday.

Composed of primary care physicians, the USPSTF is an independent panel of nonfederal experts in prevention and evidence-based medicine.

In 2008, the task force issued a recommendation against prostate-specific antigen-based screening for prostate cancer for men age 75 and older.

In October 2011, the USPSTF issued a new recommendation against the screening for all age groups.

Senate Concurrent Resolution 10, sponsored by Sen. Dave Burke, states that the task force concluded there is “moderate or high certainty” that the screening has no net benefit.

“The USPSTF recommendation against screening puts into harm’s way men who are most likely to be at risk,” said Burke, R-Marysville, who introduced the measure in the last General Assembly as Senate Concurrent Resolution 33.

“This includes the underinsured, those who live in areas where health care is not readily available, those with a family history of prostate cancer and African-American men, who have a higher incidence and mortality rate of prostate cancer than Caucasian men.”

SCR 33 was voted out of committee but did not pass the full Senate before the session ended.

SCR 10 was unanimously adopted by the Senate last month and had its first hearing before the House Health and Aging committee Dec. 17.

“An estimated 29,720 American men will die from prostate cancer in 2013 and about 238,590 new cases will be diagnosed according to the American Cancer Society,” Burke said.

“(As) the second leading cause of cancer-related deaths in men in the United States, it is vital that we continue to encourage early-detection and preventative screening as well as educational awareness.”

The resolution states that the USPSTF acknowledges that prostate cancer is the most commonly diagnosed nonskin cancer in men in the United States, with one in six American men being diagnosed with prostate cancer in his lifetime.

Burke pointed to a recent study, the Goteborg Randomized Population-based Prostate Cancer Screening Trial, which found that with screening, deaths from prostate cancer dropped 44 percent over a 14-year period, compared with men who did not undergo screening.

SCR 10 has been endorsed by the Ohio Commission on Minority Health.

Angela Dawson, the OCMH executive director, offered proponent testimony for the bill before it moved out of the Senate.

“The commission stands firmly by Sen. Burke’s resolution to discount this federal recommendation,” she said. “Due to the high number of prostate cancer deaths in this country, many occurring among men of racial and ethnic populations, PSA screening must remain available to reduce cancer deaths among men in Ohio and nationwide.”

Dawson said prostate cancer was 13.7 percent of the newly-diagnosed cancer cases reported to the Ohio Cancer Incidence Surveillance System from 2001 to 2005.

“Although this incidence rate appears to be below the national average of prostate cancer cases, Ohio’s death rate of 27.8 deaths per 100,000 males for the same time period is 2 percent higher than the national age-adjusted prostate cancer death rate,” she said.

“Being from a large family, I can easily think of six males in my own immediate family, including my husband, son, brother and nephews. As their names and faces pass my mind, it is alarming to know that they may not have the opportunity for lifesaving screenings.”

With regard to higher prostate cancer rates among black males, Dawson said the death rate in 2008 for black men in Ohio from prostate cancer was 57 percent — twice the rate of white males.

“With many cancers, such as breast and colon, early detection is key to reducing incidence and mortality of prostate cancer,” she said. “Along with knowing risk factors, like age, family history and smoking, men of all age groups should be well educated about prostate cancer, their individual risks of developing the cancer and their screening options.”

Dawson said annual PSA screenings are covered by Medicare and many private insurance plans.

“With access to quality and effective health care still being a huge barrier to many in Ohio and nationwide, it is imperative that we ensure the men of Ohio receive all health benefits currently available to them, especially if those services may prevent premature deaths and improve health outcomes,” she said.

According to the National Cancer Institute, Dawson said scientists are investigating methods to enhance the test to give physicians the ability to better distinguish cancerous cells from benign cells, as well as slow-growing cancers from potentially lethal cancers.

“However, until these studies are concluded, the current PSA test is the most viable option available to detect early stages of prostate cancer, begin necessary treatment of late-stage prostate cancer and ultimately, reduce health disparities regarding the overburden of prostate cancer cases among black men in Ohio.”

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