The new USPSTF recommendation. - Advanced Prostate...

Advanced Prostate Cancer

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The new USPSTF recommendation.

pjoshea13 profile image
10 Replies

For those interested in the new US Preventive Services Task Force (USPSTF) PCa screening recommendation, see the full text that appeared in the May 8th JAMA [1].

Although the USPSTF has rightly back-pedalled from the 2012 'no-screening' recommendation, this is a C recommendation, meaning that "there is at least moderate certainty that the net benefit is small."

Nothing much has changed, except that men aged 55 to 69 years are advised to discuss with their doctors. Alex H. Krist, MD, MPH, vice chair of the USPSTF, who is a professor {of family medicine and population health} at the Virginia Commonwealth University School of Medicine in Richmond, said that the decision as to whether to be screened for prostate cancer is "complex."

Too complex for the USPSTF, but not for one's doctor, it seems.

"USPSTF vice chair Douglas K. Owens, MD {professor of medicine, health research and policy}, from the Veterans Affairs Palo Alto Health Care System, added that screening "may be the right choice" for men "who are more interested in the small potential benefit and willing to accept the potential harms."

Does he mean "idiots"? Or perhaps I'm reading too much into Owens' choice of words - small benefit versus harm.

"Men who place more value on avoiding the potential harms may choose not to be screened," he added. [2] Implying that the downside is inconsequential.

This is quite a burden on GPs, IMO. Some patients who are later diagnosed at an advanced stage might feel that the information they received was inadequate.

-Patrick

[1] jamanetwork.com/journals/ja...

[2] medscape.com/viewarticle/89...

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pjoshea13 profile image
pjoshea13
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10 Replies
kmack57 profile image
kmack57

I wonder if he gets HIS checked ?

cesanon profile image
cesanon

"I wonder if he gets HIS checked ?"

Am I the only one who thinks Republican Death Panel?

The only interest this policy serves is to reduce healthcare costs, at the expense of healthcare. Not unlike what they currently doing with things like epidemic preparedness.

Or is this just me?

pjoshea13 profile image
pjoshea13 in reply to cesanon

I put it down to ignorance.

No urologists or oncologists in the task force.

& they are trying to protect the overtreated at the expense of men who are destined for this group.

If they were problem solvers, they would suggest that a further test occur before biopsy, such as the 4Kscore. & that insurance not reimburse for a biopsy purely on the basis of PSA.

-Patrick

cesanon profile image
cesanon in reply to pjoshea13

"that insurance not reimburse for a biopsy purely on the basis of PSA."

That would work like magic

Shooter1 profile image
Shooter1

VA told me not to worry about high normal PSA for my age and they didn't put much faith in the test.

18 months later non VA Dr. diagnosed stage 4 fast growing, invasive, aggressive, incurable it will kill you Pca. VA kind of sucks sometimes.

Doug

cesanon profile image
cesanon in reply to Shooter1

This is not limited to the VA. Not in the least.

louschu profile image
louschu

I'm voting by stopping my annual contribution.

We need facts and education instead of stupid rules to protect us from ourselves

Stegosaurus37 profile image
Stegosaurus37

"small potential benefit"? Because of "small potential benefit" Standards of Practice my PCa wasn't caught until it was Gleason 9, stage 4.

The idiots are running the asylum. So we should let men incur aggressive cancer because it would be 'not nice' to inconvenience men in general? Penny wise and pound foolish if this is thought to save money. Beware GP's or urologists with teaching positions -- they, like my GP, are more likely to toe this stupid line. I'm imagining that none of these great thinkers are dealing with prostate cancer themselves.

j-o-h-n profile image
j-o-h-n

Douglas K. Owens, M.D., M.S.

Vice-Chairperson, U.S. Preventive Services Task Force

Task Force member photo

Douglas K. Owens, M.D., M.S., is a general internist at the Veterans Affairs (VA) Palo Alto Health Care System. He is the Henry J. Kaiser, Jr., professor at Stanford University, where he is also a professor of medicine, health research and policy (by courtesy), and management science and engineering (by courtesy), as well as senior fellow at the Freeman Spogli Institute for International Studies. Dr. Owens is director of the Center for Primary Care and Outcomes Research in the Department of Medicine at Stanford and the Center for Health Policy in the Freeman Spogli Institute for International Studies. He is associate director of the Center for Innovation to Implementation in the VA Palo Alto Health Care System, a VA Health Services Research Center of Excellence.

Dr. Owens is the former director of the Stanford University-University of California, San Francisco Evidence-Based Practice Center and currently directs two training programs in health services research—the VA Physician Fellowship in Health Services Research and the VA Postdoctoral Informatics Fellowship Program. He is a past president of the Society for Medical Decision Making. In addition, Dr. Owens chaired the Clinical Guidelines Committee of the American College of Physicians, a committee that develops clinical guidelines that are widely used and regularly published in the Annals of Internal Medicine.

Dr. Owens' research focuses on guideline development, technology assessment, cost-effectiveness analysis, evidence synthesis, and methods for clinical decisionmaking. His current topics of study include the effectiveness and cost-effectiveness of preventive and therapeutic interventions for HIV in the United States and developing countries, diagnostic and therapeutic interventions for cardiovascular disease, and the effectiveness and cost-effectiveness of treatments for hepatitis C.

Dr. Owens received a B.S. and an M.S. from Stanford University and an M.D. from the University of California, San Francisco. He completed a residency in internal medicine at the University of Pennsylvania and a fellowship in health research and policy at Stanford. Dr. Owens received the VA Undersecretary's Award for Outstanding Achievement in Health Services Research, as well as the Eisenberg Award for Leadership in Medical Decision Making from the Society for Medical Decision Making. He was also elected to the American Society for Clinical Investigation and the Association of American Physicians.

Dr. Owens previously served as a member of the U.S. Preventive Services Task Force from January 2012 to December 2015, prior to his appointment as vice chair of the Task Force in May 2017.

THE FOLLOWING MAY BE DATED (AS OF 03/21/2016)

Center for Primary Care and Outcomes Research/

Center for Health Policy

117 Encina Commons

Stanford, California 94305-6006

Voice: 650 723-0933 Fax: 650 723-1919

Email: owens@stanford.edu

VA Palo Alto Health Care System (111A)

3801 Miranda Avenue

Palo Alto, California 94304

Good Luck and Good Health.

j-o-h-n Monday 05/14/2018 1:55 PM EDT

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