Sending Office: Honorable David Young
Sent By:
Nick.Crawford@mail.house.gov

        Request for Signature(s)

Deadline Extended: COB Thursday, March 15

Dear Colleague,

We ask you to join us in sending a letter to Department of Health and Human Services Secretary Alex Azar to urge him to address concerns we are hearing from doctors, nurses and cervical cancer survivors regarding draft US Preventive Services Task Force (USPSTF)
cervical cancer screening guidelines which recommend dropping the combined Pap test plus HPV test, often called “co-testing.”

Co-testing, the combination of a Pap test and an HPV test for women aged 30-65 years is the current standard of care, as it has shown significant success in identifying more cervical pre-cancer and cancer than either test alone. The absence of co-testing for
cervical cancer screenings in this draft represents a significant departure from current guidelines and creates concern that payers will deny coverage. Many of the national organizations who work most closely with cervical cancer patients, survivors, and clinicians
are supportive of the extra protection co-testing provides.

Dropping co-testing from the USPSTF’s guidelines could undermine the screening decisions between a patient and their doctor and decades of advances against cervical cancer diagnoses and deaths. Since health plans are only required to cover services with an
A or B rating by USPSTF, and they follow the Task Forces’ screening and preventive care guidelines in what they are willing to cover with no co-pay, this change has serious implications for women’s access to cervical cancer screenings.  Now is the time to
encourage routine screenings, rather than weakening coverage and access.

We hope you will join us in bringing this issue to the Secretary’s attention. The deadline for this letter is close of business on Thursday, March 15, 2018.  The timeline is limited because these guidelines could be finalized by late March.

For questions or to join the letter, please contact Nick Crawford (Rep. David Young) at Nick.Crawford@mail.house.gov or Hillary Beard (Rep. Terri Sewell) at Hillary.Beard@mail.house.gov.

 

Sincerely,

 

David Young                                                                                                      Terri Sewell
Member of Congress                                                                                          Member of Congress

 

The Honorable Alex Azar
Secretary
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201

 

Secretary Azar:

We write to bring your attention to our shared concerns with the draft cervical cancer screening guidelines from the U.S. Preventive Services Task Force (USPSTF), released on September 12, 2017. In a significant departure from previous USPSTF recommendations,
the draft does not include “co-testing” for cervical cancer screenings. Co-testing, the combination of a Pap test and an HPV test for women aged 30-65 years is the current standard of care as it has shown significant success in identifying more cervical pre-cancer
and cancer than either test alone. If finalized, the proposed guidelines could seriously undermine the strides made in reducing cervical cancer deaths and disease progression in recent years. Many of us have heard concerns from cervical cancer survivors and
their clinicians in our states. We share these concerns and urge the USPSTF to include co-testing in its final guidelines.

Last September, the USPSTF released a draft of its new guidelines for cervical cancer screening which are updated approximately every 5 years. The absence of co-testing for cervical cancer screenings in this draft represents a significant departure from current
guidelines and creates concern that payers will deny coverage. According to a growing body of evidence, co-testing identifies substantially more cancers than either the HPV or Pap test alone. Many of the national organizations who work most closely with cervical
cancer patients, survivors, and clinicians are supportive of the extra protection co-testing provides.

The Centers for Disease Control and Prevention’s (CDC) own data demonstrates that the increased use of co-testing over the last 15 years has improved the ability of doctors to find cervical cancer at an earlier and more treatable stage. According to the CDC,
co-testing has shown to prevent as many as 93 percent of new cervical cancer cases. The data also shows that from 2003 to 2012 in the United States, the death rate from cervical cancer:

  • Decreased by 0.9% per year among women.
  • Decreased by 0.6% per year among white women.
  • Decreased by 2.2% per year among black women.
  • Decreased by 2.3% per year among Hispanic women.

These are trends we need to build upon rather than curtail the progress we’ve made on saving lives and costs with screening. The incidence of cervical cancer diagnoses and deaths has decreased significantly in recent decades due to prevention and early detection,
but lack of access to screening remains a contributor to cervical cancer morbidity and mortality. Now is the time to encourage routine screenings, rather than weakening coverage and access. Dropping co-testing from the USPSTF’s guidelines could undermine the
screening decisions between a patient and her doctor and decades of advances against cervical cancer diagnoses and deaths. Since health plans are only required to cover services with an A or B rating by USPSTF and they follow the Task Forces’ screening and
preventive care guidelines in what they are willing to cover with no co-pay, this change has serious implications for women’s access to cervical screenings. Absent the inclusion of co-testing in the final guidelines, fewer physicians will offer the screening.
Even when offered, higher out of pocket costs will be a barrier for women on plans that consequently deny coverage. This poses a serious threat to the work being done to eliminate the social and racial disparity gap for cervical cancer.

We understand USPSTF could finalize its cervical cancer screening guidelines as soon as March. We hope you will take these concerns into consideration immediately. As concerned Members of Congress, we ask the USPSTF retain the inclusion of the 5 year co-testing
recommendation in its final guidelines.

Sincerely,

 

Related Legislative Issues

Selected legislative information:HealthCare

icon eDC logo e-Dear Colleague version 2.0