A War on Men
If you're at risk of prostate cancer — in other words, if you're male — the best place to be is the United States, where survival rates are highest in the world. But not for long, if the Obama administration gets its way by curtailing a test that flags prostate cancer before it spreads.
The Obama administration wants to penalize doctors who routinely order the PSA blood test. Under a proposed policy, those doctors will get demerits as overspenders, while doctors who skip the test will be rewarded with a high quality rating from the government and be paid more.
The Obama administration claims less care is better. That's double talk. An editorial in the current issue of the Journal of the American Medical Association points to a sudden, disturbing drop in prostate cancer detection since 2011, when the United States Preventive Services Task Force recommended against using this simple test. Worse, JAMA predicts more prostate cancer deaths due to the drop.
The Task Force — 16 government appointees — tried to argue that the test does more harm than good. Some men with high PSA scores undergo retests and biopsies only to find out they don't have cancer. Or they endure the side effects of radiation and surgery even though their cancer is slow growing and not life-threatening.
The Task Force claims the test's "harms" outweigh the "benefits." Not so fast. Of course it's distressing to get a call that you need to get retested because of a high PSA score, but that "harm" is nothing compared to being told your cancer has spread. Women go back to their doctors all the time for repeat mammograms. It beats dying of breast cancer.
Male patients are not pushed into biopsies or treatment on the basis of a single abnormal PSA score, explains Dr. John Williams, a New York urologist. Doctors also consider a patient's age, his prostate's size and other factors.
In truth, the Obama administration is more concerned with cutting care than preventing cancer deaths.
Fortunately cancer advocacy groups and physicians rebelled against that nickel-and-diming. That was in 2009. They need to mobilize again to defeat the assault on prostate cancer screening.
Even without these new proposed penalties on doctors, the Task Force's misguided opposition to PSA tests already has caused thousands of avoidable deaths, according to David Penson, a urological surgeon at Vanderbilt University. Many doctors stopped the test, allowing cancer to spread undetected.
"This is a warning," says Dr. Anthony D' Amico of the Dana Farber Cancer Institute in Boston. "It is likely that men will develop more advanced prostate cancer before it is diagnosed and be less likely to be cured."
Similarly, the JAMA editorial warns of advanced prostate cancer deaths "associated with the decline in PSA screening that has occurred following the USPSTF recommendation." Proof the Task Force is dead wrong.
Who in their right mind would call it "quality" to skip this test? But it's not the first time. Obama's signature health law awards quality points to the hospitals that spend the least, even though it would seem these are the hospitals where seniors are least apt to survive an illness.
Chief architect of Obama's health policies, Dr. Ezekiel Emanuel, says he has no desire to live beyond 75, so he's foregoing all treatment, including PSA tests. He's entitled to his whacky view. But the rest of us who value life, including our own, need to know the facts. The Obama administration's war on PSA tests is, in Dr. Williams' opinion, "a cold-hearted decision based on cost." It's a war on men.
Betsy McCaughey is a senior fellow at the London Center for Policy Research and author of "Government by Choice: Inventing the United States Constitution." To find out more about Betsy McCaughey and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.
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