University of Illinois Cancer Center, University of Illinois at Chicago, Chicago, IL, USA.
Department of Psychology, DePaul University, Chicago, IL, USA.
Transl Behav Med. 2020 May 20;10(2):492-494. doi: 10.1093/tbm/ibz034.
Prostate cancer (PCa) disproportionately affects African American men. Early detection reduces risk of mortality. The United States Preventive Services Task Force (USPSTF) issued an updated recommendation statement on serum Prostate Specific Antigen (PSA)-based screening for PCa. Specifically, in 2012, the USPSTF recommended against PSA-based screening due to risk for overdiagnosis and overtreatment. However, the updated 2018 guidelines recommend consideration of screening for certain at risk men and revised the recommendation rating from "D" to "C." This new guideline recommends providers to educate high-risk men on the benefits and harms of PSA-based PCa screening so that they can make an informed decision. The Affordable Care Act (ACA) includes provisions of service coverage for patient navigators who can help patients decide whether screening is appropriate, given potential risks and benefits, and training of health care providers in shared-decision regarding screening/treatment. These services can be utilized to support health care providers to better adhere to the new guideline. However, recommendations that are given a C rating or lower are not consistently reimbursed through many plans, including those offered through the ACA marketplace. The Society of Behavioral Medicine (SBM) supports the USPSTF guideline for the consideration of prostate cancer screening for high-risk men between the ages of 55 and 69. SBM encourages policymakers to include provisions for coverage of patient navigation services in the ACA to facilitate shared decision-making between providers and patients regarding screening.
前列腺癌（PCa）在非裔美国男性中发病率不成比例。早期发现可降低死亡率。美国预防服务工作组（USPSTF）发布了一项关于基于前列腺特异性抗原（PSA）的前列腺癌筛查的更新推荐声明。具体来说，USPSTF 在 2012 年建议反对基于 PSA 的筛查，因为存在过度诊断和过度治疗的风险。然而，2018 年的更新指南建议考虑对某些高危男性进行筛查，并将推荐等级从“D”改为“C”。该新指南建议提供者向高危男性宣传基于 PSA 的前列腺癌筛查的益处和危害，以便他们能够做出明智的决定。平价医疗法案（ACA）包括为患者导航员提供服务覆盖的条款，患者导航员可以帮助患者决定是否进行筛查，同时考虑潜在的风险和益处，并对医疗保健提供者进行有关筛查/治疗的共同决策的培训。这些服务可以用来支持医疗保健提供者更好地遵守新指南。然而，许多计划（包括通过 ACA 市场提供的计划）并未一致报销评级为 C 或更低的建议。行为医学学会（SBM）支持 USPSTF 关于对 55 至 69 岁高危男性进行前列腺癌筛查的建议。SBM 鼓励政策制定者在 ACA 中纳入患者导航服务的覆盖条款，以促进提供者和患者之间关于筛查的共同决策。
