A new law requiring insurance coverage of physician-ordered prostate exams raised Alabama’s grade from an “F” in 2006 to a “C” in the 2007 Prostate Cancer Report Card.
The report, issued by the National Prostate Cancer Coalition (www.fightprostatecancer.org), assesses each of the 50 states and the District of Columbia. The state grades are based on critical areas such as mortality and screening rates, support for prostate cancer-related legislation and accessibility of urologists and clinical trial sites.
In 2006, Alabama was not among the 28 states with laws requiring insurance companies to cover prostate cancer screening, said Thomas E. Moody, MD, president of Urology Centers of Alabama. In contrast, 49 states, including Alabama, mandate that insurance companies cover screening for breast cancer, he said.
“So one of the first things we wanted to do to get that criterion taken care of was to have a bill,” said Moody, who was instrumental in the successful legislative effort. “In Alabama, most of the insurance companies actually do cover it (prostate cancer screening), so it really wasn’t like people aren’t getting the care if they have insurance. But we needed to be on the books that the state of Alabama has said, ‘We think that prostate cancer is just as important as breast cancer,’ and sort of put an official stamp on it. In addition, it would be something that couldn’t be taken away in the future. In other words, if you are going to write insurance in Alabama, you’ve got to offer this.”
Sen. Rodger Smitherman, D-Birmingham, introduced the bill, which was passed unanimously in the Senate on May 29. Next, the bill was introduced in the House by Rep. Alan Boothe, D-Troy, and was passed on June 7. Gov. Bob Riley signed the bill into law on June 13.
Another criterion for the report was the number of people in Alabama who get screened for prostate cancer.
“The year they looked at, I think 50 percent of men over 50 got screened, which isn’t really bad, but wasn’t as high as it should be,” Moody said.
“The third criterion — and this is the most stunning one to me — is the death rate from prostate cancer in Alabama is the third highest in the nation. That’s directly related to the fact that a lot of people don’t get diagnosed early. If prostate cancer is diagnosed early, it’s curable, but if it’s diagnosed late, it’s not. We can treat it, but we can’t cure it. So a lot of guys are missing out because they’re not getting screened. That’s our next big push: the screening process.”
This summer, Moody spoke with the Alabama High School Athletic Association coaches and athletic directors, and conducted a screening.
“The idea was their position in the community is one of respect,” he said. “People like coaches, so we asked them to go back to their communities and talk to the men about it (prostate cancer).”
Moody said he is hopeful that U.S. Sen. Jeff Sessions, R-Ala., who led the national effort to designate September as Prostate Cancer Awareness Month, will attend a screening Oct. 27 in Camden in Wilcox County, where Sessions grew up. Also, Gov. Riley will sign a proclamation for prostate cancer awareness in Alabama, Moody said.
Other upcoming screenings will be held Sept. 8 in Marion; Sept. 30 at Sixth Avenue Baptist Church in Birmingham; and Nov. 17 in Montgomery.
“We’re working with Dr. Leon Davis (in Montgomery), who has some mobile vans that he takes out twice a week to do outreach work,” Moody said. “We’re hooking up with him to do some outreach work, particularly in regard to prostate cancer. So we’re trying to get into the community to get the word out.”
He added, “There are a lot of barriers for people to getting screened, and insurance is just one of them. There are a lot of cultural barriers, a lot of fear. Some of the people in that community don’t trust doctors, and they’re afraid not only of the screen but if they get treated, they lose their manhood. They need to realize — and what we’re trying to get out — is that even though prostate cancer is curable if it’s caught early, if it’s not caught early it’s not curable. It still causes a lot of people to die, particularly in the black community, where the incidence is higher and the cancer they get is worse. They usually get it at an earlier age, and it’s usually more aggressive.”
Moody reminds physicians of the guidelines for prostate cancer screening: “For Caucasians, they should start at age 45. For African Americans, or if you have a first-degree relative (diagnosed with prostate cancer), you should start at age 40. The screening consists of a digital rectal examination and a PSA (prostate-specific antigen) blood test.”
September 2007
