May 15, 2018
Alex H. Krist, MD, MPH
Vice Chairperson, U.S. Preventive Services Task Force
5600 Fishers Lane
Mail Stop 06E53A
Rockville, MD 20857
Re: Final Prostate Cancer Recommendations
Dear Dr. Krist:
The National Alliance of State Prostate Cancer Coalitions (NASPCC) commends the small steps taken last week by the United States Preventive Services Task Force in changing their “D” Recommendation to a “C” Recommendation for men 55-69. But the USPSTF kept the “D” Recommendation in place for men 70 and over, and did not recommend or even mention screening in men younger than 55.
NASPCC is disappointed that the USPSTF recommends against testing men 70 and over. In actuality men 70 and over who are healthy and have at least a 10-year life expectancy are appropriate candidates to be offered testing. Also, you should know that NASPCC advocates for the early detection of potentially lethal prostate cancer and calls for a baseline PSA starting at age 40. Waiting for a man to reach age 55 will miss many potentially aggressive and deadly cancers that will no longer have a chance for cure, and will increase morbidity and mortality among these patients, while increasing the number of men who are advanced at time of diagnosis or who will more likely progress to metastasis. Additionally, the Recommendations do not contain specific screening guidelines for earlier testing of African-American men nor of men with a family history of the disease. And the USPSTF does not even mention men with exposure to Agent Orange, who have an elevated risk of aggressive prostate cancer. Nor does it recognize the new tools in testing that will avoid overtreatment. The new Recommendations are similar to acknowledging that there are three necessities in life but asking men to please say how grateful they are that you’re only going to allow them one.
The National Alliance of State Prostate Cancer Coalitions is a nation-wide 501(c)(3) organization comprised of state prostate cancer coalitions dedicated to saving men’s lives and enhancing the quality of life of prostate cancer patients and their families, through awareness and education and the development of a public policy network.
MEREL GREY NISSENBERG,