Sunday, April 22, 2012

Warren Buffett and President Obama vs. USPSTF guidelines

As an 81 year old man, it's ironic that Mr. Buffett is in the demographic that the United States Preventive Services Task Force (USPSTF) recommends against screening.  The current official recommendation from this body is that people aged 75 years of age or older should not be screened.

This guideline is old and their current draft guidelines advise against screening altogether.  This new proposed guideline was released in October, 2011 and had two comment periods after release.  Their final recommendation is pending.

The new proposed guideline has drawn the ire of many groups, with the American Urological Association leading the way.

AUA page with USPSTF response

I too have been involved in the response, sending an editorial to the Concord Monitor.  In particular, I detail the interesting fact that while this controversy is going on that President Obama just had a PSA test. If the new draft guidelines were used, he would be advised against having the test.  I feel that he should have the test and continue to do so, especially since he's in an at-risk demographic by being African-American.

As stated in my prior blog post about Warren Buffett's cancer, I think using age alone is a very simplistic cutoff.  Prostate cancer is quite complex and the medical data is still evolving.  There is little controversy that there is a problem with the over diagnosis of prostate cancer.  However, diagnosis does not necessarily mean treatment.  One good aspect of this controversy is that there is more awareness that many men have very low risk disease and can be managed with active surveillance.

The bottom line is that we currently don't know which patients with prostate cancer will die of that disease.  Until this issue is further clarified with more clinical studies or a breakthrough in prostate cancer detection, men should have an informed discussions with their doctors regarding this issue on a case by case basis.  It is premature for the USPSTF to issue such a blanket statement that affects the health of millions of men in the United States.

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