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Insurers should cover full cost of prostate cancer screenings | COMMENTARY

The signature dome of Johns Hopkins Hospital lit in blue in honor of prostate cancer awareness week.
The signature dome of Johns Hopkins Hospital lit in blue in honor of prostate cancer awareness week.(Baltimore Sun photo by Kenneth K. Lam)

Editor’s note: Due to an editing error, a headline on an earlier version of this commentary incorrectly referred to the wrong kind of cancer. The Sun regrets the error.

Prostate cancer will be the most commonly diagnosed cancer among men in Maryland this year.

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Currently, Maryland requires insurers to cover screening for prostate cancer, for both the digital rectal exam test and the prostate-specific-antigen blood test. Both screening tests are important in the prevention of prostate cancer because they can detect the presence of the cancer in the body so people can get treatment as early as possible.

But many insurers don’t cover the full costs of such screenings as they do for other cancers, such as that of the breast; insurance companies cover the costs of yearly mammograms for women. Patients who get screenings for prostate cancer will share the cost of the procedure in the forms of copayments, deductibles and coinsurance.

Legislation we have introduced in the Maryland General Assembly (H.B. 852 and S.B. 661) would prohibit any form of patient cost-sharing on screenings for prostate cancer for men ages 40 to 75. This change to current law would not only save lives by making prostate cancer screening more accessible and affordable, but would also introduce parity and the same standards given to preventative screenings for women’s cancers.

Prostate cancer stems from similar genetic mutations as that of breast cancer — a single chromosome is the differentiating factor that results in an individual developing prostate cancer rather than breast cancer. Congress has passed an act that bans cost-sharing for mammograms or cervical cancer screenings. It is only fair to prohibit cost-sharing for prostate cancer tests, given that these diseases are genetically similar, and even have near-identical prevalence rates. We can start at the state level.

There is no better time to make screenings for this devastating disease more accessible and affordable as prostate cancer deaths and incidences are on the rise. This year in Maryland, nearly 4,500 men will be diagnosed with the disease — a number that’s already up 5% from last year. New reporting from the American Cancer Society shows that in 2020, the number of men who will die from prostate cancer will hit the highest rate since the turn of the century. When caught early, those diagnosed with prostate cancer have a 99% chance of survival. This is three times higher than when prostate cancer is found in an advanced stage, when there is just a 30% rate of survival.

Early screening is also more cost-effective than treating late stages of the disease. Further, it would have a nominal impact on Maryland’s insurers. A Maryland Healthcare Commission study found that eliminating cost-sharing for these tests would only cost insurers three cents per month or 35 cents per year on premiums. New York was the first state in the country to implement a similar bill. Maryland should become the second.

Our legislation provides a historic chance for Maryland to save lives. Men of Maryland — and those that care about them — should call their state legislative representatives and ask them to vote yes on H.B. 852 and S.B. 661. You have the power to help save lives.

Sen. Malcolm Augustine (Malcolm.Augustine@senate.state.md.us) and Del. Erek Barron (Erek.Barron@house.state.md.us) are Democrats who represent Prince George’s County in the Maryland General Assembly. Patrice Brown (patrice@zerocancer.org) is the vice president of advocacy and patient programs for ZERO – The End of Prostate Cancer, the nation’s leading nonprofit in the fight against prostate cancer.

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