New Jersey Was Right

New Jersey became the first state in the nation to formally oppose the draft recommendation made by the U.S. Preventive Services Task Force (USPSTF) that healthy men should no longer receive prostate-specific antigen (PSA) blood tests as part of routine cancer screening.  The joint resolution requesting the U.S. Congress to seek the withdrawal of the USPSTF’s dangerous recommendation, which was passed unanimously by the Senate and the Assembly and signed into law by the Governor, was a quick, bold and courageous move that clearly put our State on the side of early detection of cancer and, ultimately,  aving lives.  New Jersey men, especially men with a family history of prostate cancer, as well as the underinsured, men living in rural areas and African Americans, can applaud our legislature and Governor for this triumph.

Now, a new study published on March 15 in the New England Journal of Medicine has proven once again how valuable PSA screening is as a life-saving tool and just how right our leaders were in acting so quickly to seek the withdrawal of the USPSTF recommendation. A follow-up of the European Randomized Study of Screening for Prostate Cancer (ERSPC) confirmed what practicing urologists have known for decades: PSA screening saves lives.

In the study, “Prostate-Cancer Mortality at 11 Years of Follow-up,” PSA screening was shown to reduce the mortality rate of prostate cancer by 29 percent.  The ERSPC, the world’s largest prostate cancer screening study, involved 182,160 men between the ages of 50 and 74 years at entry, with a predefined core age group of 162,388 men 55 to 69 years of age. The trial was conducted in eight European countries. Men who were randomly assigned to the screening group were offered PSA-based screening, whereas those in the control group were not offered screening. The results showed that for all patients, there was a 21% survival advantage, and more importantly, for those with follow-up of more than 10 years, the survival advantage increased to 38%.

New Jersey public policy makers, including Governor Chris Christie, Senators Loretta Weinberg and Joseph Vitale and then-Assembly members Joan Quigley and Alex DeCroce quickly understood the dangers inherent in the USPSTF recommendation against PSA screening.  Senator Weinberg remembered that the USPSTF was the very same task force that, in 2009, recommended against mammograms for women ages 40-49 and against teaching women to do breast self-exams.  Our legislators understood the seriousness of the USPSTF’s latest recommendation and in a show of bi-partisan support unanimously passed the resolution in both houses – sending a clear message to men in New Jersey  who, upon hearing news reports of the USPSTF recommendation, might decide to forego routine PSA screening.

It is important for patients to know that PSA screening is not treatment. It is a simple blood test. There are essentially no risks to screening, and with screening results, patients have the information they need to consult with their families and their doctors to make better informed decisions about their health.

African American men are especially in need of this information as well as those with a family history of prostate cancer. The facts are not in dispute: One in six men will be diagnosed with prostate cancer in his lifetime and this figure increases to one in five for African-American men; and African-American have more than twice the prostate cancer mortality rate of white men.

As Chairman of the New Jersey Patient Care and Access Coalition (NJPCAC), a coalition of nearly 200 practicing urologists and scores of additional healthcare professionals, including radiation oncologists, pathologists, and nurse oncologists from across the state, I understand what is at stake here. We are united in our opposition to this new recommendation and we have good reason. According to the American Cancer Society, approximately 7,840 New Jersey men will be diagnosed with prostate cancer this year. Roughly 1,100 of them will eventually die from the disease. And while that is an unacceptable number and we can do better, it is significantly better than a few short years ago because of PSA screenings.

Few would disagree that the decision on how and when to screen and treat prostate cancer should stay where it has always been: between patients and their doctors. As a physician, I have been trained not to be an alarmist nor to be prone to exaggeration, but I believe that the USPSTF draft recommendation, if finalized, will cause the needless deaths of thousands of men. As the State of New Jersey has unanimously stated, the USPSTF recommendation must be rejected.

Dr. David Taylor is President and Chairman
of the New Jersey Patient Care and Access Coalition. He is also President of
Garden State Urology and practices in Morristown, NJ.