Why isn't prostate cancer screening covered by OHIP?

[Bob Macadoo]

Yes as I've already shown the benefits are questionable...but apparently that isn't important to the discussion.

Too often how these threads go......thanks for some sanity.

Unlike....blah blah blah Obamacare dig.....

[Icebound]

It is important, that's why I changed my original opinion on the matter. It's ineffective as a screening tool and it's covered as a test when ordered by a doctor (just not as a routine screening measure). Seems fine. My biggest exception was the government deciding not to cover doctor-ordered treatments and diagnostics. I believe anything a doctor deems necessary ought to be covered by the medicare.

The reason that the cost of health care in the USA is so high... relative to other countries with similar health outcomes.... is that people (or insurance companies) ... are paying for all kinds of procedures and medications which have, ultimately, questionable benefit on health outcome.

If you want to hold costs down, then you pick those procedures that are shown to have significant benefit.

... and anyway ... there is nothing to prevent you taking the test if your doctor suggests it... you just pay for it yourself.

[MiddleClassCentrist]

As an aside (because inevitably the thread will end up going there), this right here is what irks me about so-called Men's Rights Activists (MRAs). Instead of being inflammatory anti-feminist morons, MRAs should be focused on real issues like this one. This uniquely men's issue is about access to proper life-saving healthcare. While MRAs are busy complaining about women's groups and feminists, they're ignoring real issues that they should be addressing.

To be fair, many feminists also spend a good deal of time on "low importance" issues like reframing school dress codes as "slut shaming" instead of professional dress habits and rationalizing sexist stereotypes and sexist ideas of men based on feminist blogs/literature. Note: I said "many" and not "all" or "most". I think the MRA has caught on to the false stereotyping and is responding irrationally in many contexts because they are realizing that they have a right to be offended and are using the fire from becoming offended to react hotly back instead of using it productively.

That being said, when I was reading about the screening being stopped it was because of too many false positives that lead to surgery which left males incontinent for the rest of their life and that most men who die with prostate cancer, do not die with prostate cancer as a cause of death... but old age. I can't remember whether my information is good or not, I believe that it was second hand. I'll have a browse through some of the links in the thread.

[hitops]

So yeah, here's the thing. My concern is with the government deciding for doctors what procedures should and should not be done by determining what they will fund. That's my concern.

It's a non-starter here since this procedure is covered when it's ordered by a doctor, but not covered when it's used as a screening.

They don't determine what should and should not be done, they determine what they will pay for.

Saying there is no prostate screening is misleading. What you mean is there is no PSA screening. Prostate cancer can still be screened by rectal exam. PSA is still covered in all other situations other than screening.

Part of the issue too, is that there is probably isn't a useful reason to be screened for prostate cancer anyway. Knowing doesn't change the outcome all that much in most cases. The difference in the survival rates for those who get treatment and those who don't is quite often negligible. "Watchful waiting" is increasingly being preferred.

http://www.cancer.org/cancer/news/expertvoices/post/2012/01/18/to-treat-or-not-to-treat-prostate-cancer-that-is-the-question.aspx

It needs to be pointed out that this does not say prostate surgery is not useful in general, these findings apply to only some patients depending on their risk as evaluated by biopsy, PSA and rectal exam. For low risk patients, active surveillance is considered standard now across most of Canada. However that means you need to keep an eye on it, which means routine rectal probes with biopsies.

It is important, that's why I changed my original opinion on the matter. It's ineffective as a screening tool and it's covered as a test when ordered by a doctor (just not as a routine screening measure). Seems fine. My biggest exception was the government deciding not to cover doctor-ordered treatments and diagnostics. I believe anything a doctor deems necessary ought to be covered by the medicare.

Even in the cases where gov does cover everything I order (which in reality is a good 90% of what I would order), the government provides a socialist health model which means some tests can take months or even years. That's the same as not providing them. The current waitlist for an MRI in my city is about 3000 people. Access to wait for a test is not access to a test.

That being said, when I was reading about the screening being stopped it was because of too many false positives that lead to surgery which left males incontinent for the rest of their life and that most men who die with prostate cancer, do not die with prostate cancer as a cause of death... but old age. I can't remember whether my information is good or not, I believe that it was second hand. I'll have a browse through some of the links in the thread.

That's right, that's why it's not pushed as much today. The US preventative task force also recommended against screening with PSA.

Edited June 19, 2014 by hitops