AUA Urology Advocacy Summit 2023: Breaking Down Barriers to PSA Screenings

(UroToday.com) The 2023 AUA Summit included a session by Dr. Arthur Burnett, Dr. Adam Muphy, and patient advocate Dr. Patrick Bingham, entitled “Breaking Down Barriers to PSA Screenings.” Dr. Burnett began the talk provided a history of the PSA screening recommendation from the United States Preventative Screening Task Force (USPSTF), that historically recommended against prostate cancer screening through a Grade D rating. After significant advocacy from urologists, patients, and prostate cancer/urologic organizations, the USPSTF amended their recommendation to a Grade C, recommending shared decision making for certain men allowing for screening.

He outlined the implications that USPSTF screening recommendations have on prostate cancer screening rates. From a financial standpoint, given the Grade C rating, patients are subject to out-of-pocket cost sharing that can be a major financial barrier to access. Regarding attitudes surrounding screening, given the low grade, high-risk patients may think PSA screening is not necessary or appropriate.

Next, Dr. Bingham shared his personal story about his own prostate cancer diagnosis journey, and the work that he has done to increase awareness about prostate cancer screening. He introduced the “PSA Screening for HIM Act” and reported that it is currently awaiting introduction by Congressman Larry Buchson. The bill requires private insurance plans to cover preventive prostate cancer screenings not already covered under the recommendations of the USPSTF for African American men and men with a family history of prostate cancer, eliminating any cost-sharing or out-of-pocket cost to the patient.

Subsequently, Dr. Murphy highlighted recent evidence that suggests a coverage benefit for PSA screening in Black men would improve disparities in prostate cancer outcomes. A recent study by Yomah et al published in JAMA Network Open in the Veterans Affairs health system identified major differences in incidence contributing to the disparities between African American vs. White veterans, but noted nearly equal response to treatment after diagnosis.

Dr. Burnett concluded the session by acknowledging the distrust that African American men have in the medical system and the importance of Black, and specifically Black male urologist community outreach in improving trust that was a function of systemic racism in healthcare.

Presented by:
  • Arthur Burnett, MD, MBA, Distinguished Professor of Urology and Professor, Oncology Center, at the Johns Hopkins University School of Medicine
  • Adam Murphy, MD, MBA, MSCI, Northwestern Medicine, Cook County Health and Jesse Brown VA Medical Center
  • Patrick Bingham, PhD, Patient Advocate, ZERO Prostate Champion

Written by: Ruchika Talwar, MD, Urologic Oncology Fellow, Vanderbilt University Medical Center, @RuchikaTalwarMD during the 2023 AUA Annual Urology Advocacy Summit, Washington, DC, February 27 – March 1, 2023

References:

  1. Yamoah K, Lee KM, Awasthi S, et al. Racial and Ethnic Disparities in Prostate Cancer Outcomes in the Veterans Affairs Health Care System [published correction appears in JAMA Netw Open. 2022 Feb 1;5(2):e222773]. JAMA Netw Open. 2022;5(1):e2144027. Published 2022 Jan 4. doi:10.1001/jamanetworkopen.2021.44027