The story line on 2011 is simple: It’s healthcare reform and the continuing call for providers to hold the line on healthcare costs while improving quality. This week on Repertoire’s blog we’ll take a look at some of the leading stories of 2011 based off of the December issue’s cover story. For the full story and issue visit




News about diagnostics was rampant in 2011, and virtually all of it generated some buzz…and controversy.


In October, it was reported that the U.S. Preventive Services Task Force  – an independent panel of experts in prevention and evidence-based medicine, which advises the U.S. Food and Drug Administration – would not endorse HPV screening for cervical cancer, and it favored giving Pap tests only three times in women between ages 21 and 65.


Days later, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices approved recommendations for routine vaccination of males 11 or 12 years old with three doses of HPV4 to protect against human papillomavirus. (Prior to that time, CDC had recommended that 11- and 12-year-old girls receive the vaccine, as well as girls and women aged 13 through 26 who have not yet been vaccinated.) “The HPV vaccine will afford protection against certain HPV-related conditions and cancers in males, and vaccination of males with HPV may also provide indirect protection of women by reducing transmission of HPV,” the Committee said.


Just two weeks prior to its recommendations regarding HPV screening and Pap tests, the Task Force raised a storm when it recommended against PSA-based screening for prostate cancer in all age groups. (Three years earlier, the Task Force had recommended against PSA-based screening for prostate cancer in men aged 75 years and older, and concluded that the evidence was insufficient to make a recommendation in younger men.)


The American Urological Association criticized the Task Force’s recommendation regarding PSA, which, it said, could “ultimately do more harm than good to many men at risk for prostate cancer.”


“[I]t is our feeling that, when interpreted appropriately, the PSA test provides important information in the diagnosis, pre-treatment staging or risk assessment and monitoring of prostate cancer patients,” the AUA said in a statement. “Not all prostate cancers require active treatment and not all prostate cancers are life-threatening. The decision to proceed to active treatment is one that men should discuss in detail with their urologists to determine whether active treatment is necessary, or whether surveillance may be an option for their prostate cancer.”


On the bright side – particularly for sellers of diagnostic tests – was the news, announced in June by the Centers for Medicare & Medicaid Services, that approximately 5.5 million people with traditional Medicare used one or more free preventive benefits offered by 2010’s Patient Protection and Affordable Care Act. Effective Jan. 1, 2011, the law eliminated Part B coinsurance and deductibles for recommended preventive services, and provided annual wellness visits at no cost to beneficiaries.


Among the preventive services offered with no out-of-pocket costs by Medicare are bone mass measurement, Pap tests, screening mammography, most screening procedures for colorectal cancer, fecal occult blood tests, prostate-specific antigen (PSA) tests and diabetes screening tests. (See August 2011 Repertoire.)



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