Navin Shah Screening:

Dr. Navin Shah, an Indian American urologist, has pushed for more prostate cancer screenings in men, and now the Centers for Medicare and Medicaid Services has agreed to allow for prostate cancer screenings for Medicare beneficiaries over 50 years old. (photo provided)

Maryland urologist and co-founder and former president of the American Association of Physicians of Indian Origin Dr. Navin Shah continually pushed forward the importance of prostate cancer screenings for the elderly, and the results of that persistence have been fruitful.

Shah, a diplomate of the American Board of Urology as well as the American Board of Quality Assurance and Utilization Review Physicians, tells India-West that he has been in correspondence and discussions with the Centers for Medicare and Medicaid Services in a years-long effort which has resulted in the CMS agreeing to allow for prostate cancer screenings for Medicare beneficiaries over 50 years old.

Men 70 years and older are more likely to get prostate cancer, more metastasis of prostate cancer, and are the victims of more prostate cancer-related deaths, the Indian American physician notes.

Shah and his team, over the past half-decade, have published six papers as well as nine letters to the editor in the U.S. Urology Journal on prostate cancer with a focus on having more high-risk men — particularly African Americans; men who have a family history of prostate cancer; and all healthy men over 70 years of age — to be screened more regularly.

The prostate gland is present in males and is located at the opening of bladder into the urinary channel. Prostate cancer is the No. 1 cancer in males and causes about 10 percent cancer deaths in males, Shah said.

The U.S. Preventative Services Task force in 2012 recommended against prostate cancer screening despite a reduction in prostate cancer mortality by 50 percent due to prostate cancer screenings of 20 years — based on a faulty study as recorded by New England Journal article, Shah notes.

In 2014 Shah sought help of the American Urological Association to oppose the USPSTF's guidelines. As the AUA did not help Shah published a paper in U.S. Urology Journal proving prostate cancer screening helps, he went to meet with Congressman G.K. Butterfield, the chair of the Black Caucus, and Sen. Jeff Sessions, who would introduce bills in the House and Senate to rectify the USPSTF recommendations.

Shah met with committee members of the House and the Senate. They all supported him but ultimately the bills did not get marked up and no actions were taken, he said.

In the last five years, half of internists and general physicians do not offer prostate cancer screenings to men 70 years and older. In 2016 the CMS ruled that any physician offering prostate cancer screenings to men 70 years and older will be labelled as a low-quality physician, the Indian American urologist added.

However, Congress stepped in to help — specifically, 16 physicians in the House — by writing to oppose the CMS policy. Within months, the CMS withdrew its "low-quality physician" policy.

In 2018, the USPSTF awarded grade C to prostate cancer screening for men 55 to 69 years of age; the USPSTF also continued against the screenings of men 70 years and older, according to Shah.

Shah said that in 2018, 3,000 more cases of prostate cancer were recorded and also 3,000 more deaths due to the disease occurred, as compared to 2017. The cost of prostate cancer care has increased to $15.3 billion in 2018 from $11.8 billion in 2010, he noted.

"My endeavor is to inform all Medicare male members and providers of the coverage of an annual PCa screening," he wrote in an email to India-West. "I have requested CMS to quickly inform all participants and providers — especially to internists, general physicians, urologists, oncologist and radiation oncologists," he said.

By spreading his message, Shah hopes those getting screened for prostate cancer will "greatly reduce PCa morbidity and mortality as well the cost PCa care."

He stresses that early-stage treatment prostate cancer offers a cure. Presently there are 3 million prostate cancer survivors in the U.S.

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