Plan to Limit Some Drugs in Medicare Is Criticized

[lostincalifornia]

67. I am sorry, most experts in the field of Prostate Cancer would disagree with you. What has changed

is the trend toward Active Surveillance, but I am sorry, anyone over 55 unless a family history, or other symptoms occur, who is not being screened for PCa is making the decision that it is better to live in ignorance. John Hopkins, Harvard, Mayo Clinic, and every other major institution does not agree with that conclusion. The AUA does not agree:

“The main point is that PSA testing for early detection of prostate cancer has an important role in maintaining the health of American men,” Wolf said. “Clearly, it has been overused in the past, but we feel it is a grave mistake to react to that overuse by completely getting rid of any early-detection efforts at all. We feel that a more balanced approach—selecting men at higher risk—is a more appropriate way to go.”

The issue is far from decided in regarding screening for PCa, though the bean counters and biostatisticians would like you to believe otherwise.

http://www.oncologypractice.com/oncologyreport/single-view/urologists-back-psa-screening-rail-against-uspstf-s-position/ae6807c2203aa24678b0222cd0aaa932.html

http://www.healthnewsreview.org/2012/05/reactions-to-uspstf-prostate-cancer-screening-recommendations/

The issue is what to do if something is found. That is where the changes have occurred. The technology is there to help determine if the tumor is aggressive or intermediate, or low, and whether active surveillance is prudent. I won't list the guidelines used, but they avoid unnecessary treatment, and treat when necessary. The U.S. Preventive Services Task Force (USPSTF) did not have one urologist on the committee that made that recommendation.

http://www.drcatalona.com/quest/quest_fall09_5.htm

In your view it may be settled, but not in the mind of most urologists today.

The mammography report is also flawed:

"“Mammography is an imperfect test at best, but at this point, it’s the best test we have,” said Dr. Ann Partridge, a breast oncologist at Dana-Farber Cancer Institute. She and others highlighted some potential methodological flaws of the Canadian study.

For example, Partridge said, technology has improved significantly over the past 30 years with X-ray machines and digitized film that yield clearer images.

Others have questioned whether the women in the Canadian study were properly randomized since a significantly higher number of women in the mammography group were diagnosed with advanced cancers during the first year or two of the study than those in the control group.

“This might have been due to chance,” Wender said, “but if the randomization wasn’t done perfectly, some women at higher breast cancer risk might have been put into the mammography group and this might have skewed the results.”

Some radiologists have sharply attacked the study investigators, accusing them of having a bias against mammography by designing a study in which the control group of women in their 50s received breast exams performed by skilled nurses every year instead of mammograms.

“The principal investigator set out to prove that all you needed to do was a physical examination,” said Dr. Daniel Kopans, director of breast imaging at Massachusetts General Hospital, in an e-mail responding to the new study finding. “The nurse examiners were highly trained while the radiologists and technologists [who performed the mammograms] had no training.”

http://www.bostonglobe.com/lifestyle/health-wellness/2014/02/11/study-questions-value-mammography-reduce-breast-cancer-deaths/fQGBGHqCOZSKFRGhPgjULK/story.html

Medicare still pays for PSA and mammograms, and it isn't due to politics. It is well know that catching cancer when it is localized is more easily controlled than when it has spread, and if knowing diagnostically someone has an Adenocarcinoma in its early stages, and determining whether Active Surveillance is a viable option.

Deaths from both Prostate Cancer and Breast Cancer have decreased because of early detection.

The point is, the patient/doctor needs to make these decisions, not some task force trying to save money for the government.

As for Colonoscopy you are correct, that is still recommended.