Prostate Cancer Screening for African American Men: The Impact on Public Policies

1. Prostate Cancer Screening for African American Men: The Impact on Public Policies Scott T. Williams Vice President Men’s Health Network

2. Men’s Health Network • Men's Health Network (MHN) is a national DC based non-profit organization, founded in 1992, whose mission is to reach men and their families where they live, work, play, and pray with health prevention messages and tools, screening programs, educational materials, advocacy opportunities, and patient navigation. • Reach Men and Their Families - Live, Work, Play, and Pray • Men at Work • Healthy Sunday • Community Health Centers, etc. • Sports/Entertainment Franchises

3. Impact on Public Policies

4. USPSTF - Core/Basic Benefits Package • The U.S. Preventive Services Task Force (USPSTF), first convened in 1984, and since 1998 sponsored by the Agency for Healthcare Research and Quality (AHRQ), is an independent panel of private-sector experts in prevention and primary care • Its recommendations are considered the "gold standard" for clinical preventive services • The mission of the USPSTF is to evaluate the benefits of individual screenings/services • Makes recommendations about which preventive services should be incorporated routinely into primary medical care

5. USPSTF - Core/Basic Benefits Package • The key issues • Within currently debated healthcare reform legislation, the USPSTF would serve as the foundation/ground floor for recommendations and access to specific screenings/services • However, the USPSTF does not currently recommend prostate cancer screening • Prostate Cancer screening is currently rated “I” – current evidence is insufficient • The USPSTF concludes that for men younger than age 75 years, the benefits of screening for prostate cancer are uncertain and the balance of benefits and harms cannot be determined. • Current composition of the USPSTF

6. Health Benefits Advisory Committee • Current healthcare reform legislation would establish a Health Benefits Advisory Committee (to determine screenings/services above and beyond the USPSTF) • PARTICIPATION.—The membership of the Health Benefits Advisory Committee shall reflect providers, consumer representatives, employers, labor, health insurance issuers, experts in health care financing and delivery, experts in racial and ethnic disparities, experts in care for those with disabilities, representatives of relevant governmental agencies, and at least one practicing physician or other health professional and an expert on children’s health and shall represent a balance among various sectors of the health care system so that no single sector unduly influences the recommendations of such Committee. • However, no experts in men's health or women's health are represented • Who will represent Prostate Cancer screenings and issues? • Also, a key issue will be the time necessary to implement

7. Welcome to Medicare Physical • Medicare covers a one-time preventive physical exam within the first 12 months • The exam will include a thorough review of your health, education and counseling about the preventive services you need, like certain screenings and shots, and referrals for other care • Great way to get up-to-date on important screenings and shots and to talk with your doctor about your family history and how to stay healthy • Initial preventative physical examination for a man entering Medicare provides for prostate cancer screening tests as defined: • A digital rectal exam • A prostate specific antigen (PSA) blood test • Learn more at: http://www.medicare.gov/health/physicalexam.asp

8. Prostate Cancer - State Mandates • A health insurance “mandate” is a requirement that an insurance company or health plan cover (or offer coverage for) common benefits/screenings • Prostate cancer screening is currently mandated in 37 states (Arkansas was the most recent to add it). • If the currently debated healthcare reform legislation follows the recommendations of the USPSTF and the Health Benefits Advisory Committee, that would mean over 35 million men, between the ages of 40 and 64, now living in the 37 states affected by this change would potentially no longer be required to provide prostate cancer screenings

9. Sen. Dodd & Prostate Cancer • Diagnosed on Friday, July 31st, 2009 • “A blood test (PSA) during an annual physical six weeks ago indicated the possibility that he had cancer. A subsequent biopsy confirmed the diagnosis, he said.” (NYTimes article 07/31/09) • August 11, 2009, Dr. Peter Scardino, Chairman, Department of Surgery at Memorial Sloan-Kettering Cancer Center released the following statement: • “This morning, Senator Dodd had surgery to treat his early stage prostate cancer. The surgery was successful.” • Clearly shows benefit PSA screening and early detection

10. President Obama's remarks • August 11th, 2009 – Portsmouth, NH Town Hall • We will require insurance companies to cover routine checkups and preventative care…there’s no reason we shouldn’t be catching diseases like breast cancer and prostate cancer on the front end. That makes sense, it saves lives; it also saves money – and we need to save money in this health care system.” • August 15th, 2009 Weekly Address: • “We’ll require insurance companies to cover routine checkups and preventative care…because there’s no reason we shouldn’t be saving lives and dollars by catching diseases like breast cancer and prostate cancer on the front end.”

11. Democratic National Committee Resolution • Men’s Health Network worked with the DNC to pass a Resolution during September 10 – 12, 2009 meeting in Austin, TX • “BE IT RESOLVED, that the DNC urges action to promote prostate cancer screening and testing” • You can find it online at: http://www.menshealthnetwork.org/library/DNCPCa0909.pdf

12. MHN Op-Ed - Sept. 2009 • James Morning, a prostate cancer survivor, is a retired Air Force master sergeant who was exposed to Agent Orange. He is a state coordinator for the Men's Health Network. • When you receive your PSA test results, ask the doctor what your PSA number is, write it down, and compare it against future tests. If the number goes up in future tests, talk to your doctor. • September is Prostate Cancer Awareness Month. It’s the perfect time to call your doctor, schedule an appointment, and get your prostate cancer test done. Then, talk to your doctor and determine what screening and treatment options are best for you and your family.

13. Involve Women in the Debate • Women Against Prostate Cancer (WAPC) is a national organization working to unite the voices and provide support for the millions of women affected by prostate cancer • WAPC advocates prostate cancer education, screening, policy, and treatment options. • They are passionately equipping other women with knowledge, understanding, and resources when their partner is diagnosed with the disease. • With an estimated 2 million men in the U.S. currently living with prostate cancer and another 192,000 who will be diagnosed this year, there are women nationwide looking for advocacy opportunities • Check them out at: www.womenagainstprostatecancer.org

14. Contact Me: Scott T. Williams Vice President Men's Health Network Office: 202-543-6461 ext. 103 scott@menshealthnetwork.org