November 7, 2015
Albert L. Siu, M.D., M.S.P.H., Chairperson, U.S. Preventive Services Task Force provided the following comment in response to Malecare’s set of questions regarding how patient input might influence the recent call for comments regarding the USPSTF plan to review it’s 2012 recommendation against use of the PSA test for prostate cancer screening.

*1- Is the USPSTF starting from scratch or simply reviewing to either
confirm or revise the 2012 PSA screening recommendation?*

We strive to keep our recommendations current by updating them every 3 to 5
years. We released our last prostate cancer screening recommendation in May
2012. For each recommendation update, the Task Force conducts a full review
of the available evidence to determine the balance of benefits and harms.
The draft research plan is the first step in that process.

*2- What prompted the USPSTF to revisit the PSA screening recommendation?*

Updating recommendations every few years is a part of our usual process.

*2A- Did public opinion regarding the 2012 recommendation influence the
initiation of these current activities?*

No, this is a part of our usual process. We strive to keep our
recommendations current by updating them every 3 to 5 years.

*3- How does the USPSTF receive the public comments…are they summarized
and then presented to committee members or presented fully as they were
written by the comment maker?*
Each draft research plan is posted on the Task Force’s website for public
comment for 4 weeks at:
http://www.uspreventiveservicestaskforce.org/tfcomment.htm

Members of the Task Force review each and every comment received on the
draft research plan in full.

*4- Where in the review process are public comments considered by the
USPSTF?*

Public comments are considered by the USPSTF during the finalization of a
research plan. A research plan guides the scope, conduct, and content for
the evidence review – this evidence review is the foundation of all USPSTF
recommendations. By gaining input at the beginning of the recommendation
process, the Task Force hopes to ensure that its final recommendations are
accurate, reliable, and useful.

The Task Force also posts draft recommendations for public comment, and
reviews those as it finalizes a recommendation.

*5- Are the comments distributed to committee members prior to committee
meetings?*
*6- Does a designated committee member read and take the role of
representing the public commenters?*
*7- Does the committee include an agenda item for “discussion of public
comments” during its meetings.*
*8- Are comments separated out by those made by patients, family, doctors,
researchers, etc. ?*
*9- Does the committee make specific, private or in camera requests to
specific people whose comments they particularly value?*

Members of the Task Force review each and every comment received on the
draft research plan. This may happen at or with meetings, conference calls
or email. The Task Force reviews summaries of the public comments as well
as the individual comments.

The USPSTF is committed to understanding the needs and perspectives of the
public it serves, and encourages contributors to share experiences, which
may include personal and identifying details, and release of such comments
could directly violate the Task Force’s assurance of confidentiality and
anonymity. We are most interested in the content of the comments we receive
and are looking for ways to make our recommendation statements more clear,
more accurate, and more useful.

*10- Please characterize the weight that public comments had on the 2012
PSA recommendation and what the committee hopes will be the weight of
influence that public comments will have on the current activities.*

The draft recommendation statement for prostate cancer was posted for
public comment in 2011. A summary of the public comments and the Task
Force’s response to those comments can be read here:
http://bit.ly/1Nq2ehE

Since then, the Task Force has also begun to solicit public comment on the
draft research plan to ensure the USPSTF is asking the right questions and
that it will have the best evidence upon which to develop its
recommendations.

*Additional Comments by Dr Siu: *

The timing of the draft recommendation will be dependent upon a number of
factors, including the number of public comments received on this draft
research plan and the amount of time it will take to review and consider
each comment. The Task Force tries to move each topic through the
recommendation development process efficiently, while allowing the time
necessary to come to a thoughtful, well-informed recommendation. In
general, it takes two and half to three years- from the initiation of the
work plan to review the literature up to the final recommendation – for the
Task Force to update a major recommendation. Some recommendations may take
longer than others to develop and finalize for several reasons, such as the
scope and complexity of the issue, the time needed for additional
consideration of public and partner feedback, or other factors such as the
publication schedules of journals.

Generally, it can be a couple months to over a year between topic stages.
The Task Force is currently working on updating over 30 topics, you can see
the list of in-progress topics here:
https://web.archive.org/web/20180624154654/https://www.uspreventiveservicestaskforce.org/Page/Name/topics-in-progress

Malecare thanks Dr. Siu for replying to our questions. We will continue to stay in touch with Dr. Siu and post updates and more questions and answers as this issue unfolds. We invite you to send us your questions for our next round with Dr. Siu. Please email your questions to:
darryl@malecare.org