Richard Finger, Huffington Post - Deep in the basement of an obscure but overly powerful government bureaucracy, directives are issued with far reaching implications. The Centers for Medicare & Medicaid Services, more recognized as simply "Big Brother," arbitrates hundreds of billions of dollars in payments to doctors and, more insidious, what types of treatments are eligible for reimbursement.
The latest submission from these medieval thinkers is a proposal to defund prostate cancer screening and biochemical surveillance of known disease "for all men over 18, regardless of risk factors." The directive titled "Non-Recommended PSA-based screening" would financially penalize physicians for ordering this simple blood test.
According to Houston, Texas-based, board-certified, urologist Dr. Robert J. Cornell, "denying PSA screening is both dangerous and irresponsible. This measure directly contradicts practice guidelines established by the American Urological Association who dictates best-practice protocols derived from irrefutable clinical data demonstrating both a stage migration toward more favorable disease and an improved cancer-specific survival for those men whose cancer is detected through routine screening." Additionally, as Dr. Cornell identifies, guidance issued by the American College of Physicians, the American Society of Internal Medicine, and the American Cancer Society all discourage this mandate that ignores the life-saving success the urologic community and its patients have enjoyed over the past 25 years.
Prostate cancer has been relegated to a disease with little morbidity and even less mortality. With early detection that relies on the interpretation of PSA screening, the 10-year life expectancy of men diagnosed with prostate cancer approaches 98 percent. This success stems not from the benign nature of the disease, but because of the effectiveness of surgical and radiotherapy treatments and the ability to lay dormant the progression of this cancer with hormonal therapy before it has become locally advanced or metastatic. Dr. Cornell emphasizes, "no man in the U.S., following the strict staging recommendations established by our specialty board, should ever die of prostate cancer. Death from this disease almost always represents a delay in presentation or overt treatment neglect, and such triumph will be egregiously adulterated by this government-mandated PSA restriction".
.... In a formal comment to the CMS on their proposal, published on November 30 and distributed to their membership, the American Urological Association (AUA) wondered why they were neither notified nor consulted before such a potentially draconian health measure was proposed. Indeed, not a single urologist was invited to represent the physician group that is responsible for treating this disease process and the complications that will certainly arise from its neglect. If I were a conspiracy theorist, I would say something fishy was going on.