2012 USPSTF Recommendation Against PSA Testing did not Adequately Assess the Needs of Black Men
(Boston, MA)—Nov. 20, 2015—The Prostate Health Education Network (PHEN) announced today that it has mobilized members of its national PHEN Survivor Network, partners and supporters to raise their voices to the U.S. Preventative Services Task Force (Task Force) by providing comments on its Draft Research Plan for Prostate Cancer Screening. The deadline for public comment is Thanksgiving Day; Thursday, November 26, at 8:00 p.m.
The Prostate Cancer Screening Debate:
“During this period for public comment, it is crucial that the Task Force understands that the prostate cancer early detection needs of African American men should be a key consideration in developing its new screening recommendation. This was not done in 2012 with the Task Force’s highly controversial recommendation against PSA screening for all men regardless of their risk for prostate cancer,” said Thomas A. Farrington, PHEN president and founder, a prostate cancer survivor himself. This recommendation ignited a major medical debate that is to be addressed with the Task Force’s current review of scientific evidence on the benefits and risks of screening that the research plan will guide.
PHEN Mobilizes Leaders and Specialists to Get Guidelines Changed:
Since that 2012 Task Force decision, PHEN has continuously advocated for the needs of Black men to be addressed. In 2013 the organization issued its own Consensus Statement on PSA Testing for African American Men for the Early Detection of Prostate Cancer.
During “Prostate Cancer Awareness Month” Farrington authored the forward for a Media Planet special edition on prostate cancer distributed by USA Today, titled “How Do We Take the Fight Forward?” wherein he pointed out: “The Task Force’s negative recommendation included men at the highest risk for prostate cancer, though they were not fairly represented in the data it used…..many consider the Task Force’s position an abandonment of this population.”
Dr. Daniel Barocas, Assistant Professor of Urologic Surgery, Vanderbilt University-Ingram Cancer Center presented at PHEN’s “Eleventh Annual African American Prostate Cancer Disparity Summit” on September 17th about the negative impact that the 2012 USPSTF recommendations is having on African American men. “Some men are at high risk for prostate cancer and should be screened, he said. These include men with a family history of prostate cancer, and black men.”
PHEN’s Call to Black America to raise it voices to the Task Force:
To respond to the opportunity to provide comments on the USPSTF’s research plan PHEN has drafted a set of comments that can be submitted by individuals and organizations to support the needs of Black men which can be found in its entirety on its website here.
The comments include:
- African-American men (AAM), the population most impacted by prostate cancer (PCa) within the United States, are deemed a “high – risk population” for the disease. According to the National Cancer Institutes’ SEER data, AAM have a PCa incidence rate 1.6 times higher than men of European (EM) descent in the U.S., and a mortality rate that is more than 2.4 times higher than EM. This racial disparity is the largest for any type of major cancer. U. S. Senate Resolution 529, passed in 2012, recognized PCa among AAM as a health crisis of epidemic proportion. In addition, studies show that AAM are diagnosed at an earlier age than other populations with more aggressive disease.
- The USPSTF research plan should make provisions to thoroughly assess the benefits and harms of PSA early detection screening for high-risk populations, with the AAM population being at the highest risk level. The research plan should reflect a clear categorization between average-risk populations and high-risk populations at every level of design (population, setting, interventions, comparisons, outcomes, durations, study designs, study quality, language and timeframe). Studies without an AAM participation rate of at least 10 percent should not be included as evidence for the high-risk category.
- The USPSTF recommendation should include separate recommendations for high-risk and average-risk populations based entirely on the evidence for each risk category. There should be no extrapolations or assumptions of evidence across the high-risk and average-risk categories where data may be absent.
Farrington emphasizes “These comments are intended to support the USPSTF efforts to develop a fair and effective PSA test screening recommendation for all men, and to insure that the assessment of benefits and harms of prostate cancer screening for the populations at high-risk for prostate cancer are not minimized, or subjugated, as they were with USPSTF’s 2012 prostate cancer screening recommendation.”
PHEN encourages all of those who wish to offer public comment to USPSTF, in support of the need for PSA testing for African American men and other men at high-risk for prostate cancer to use this step-by-step process. You can also email rapcancer@prostatehealthed.org or call (617) 481-4020 and PHEN’s staff will guide you through the process by the deadline of Thursday, November 26, at 8:00 p.m.
