It’s time for Ontario government to offer free PSA tests for men

It’s discrimination and it could be deadly.

There have been renewed calls recently for the Ontario government to reconsider its discriminatory policy that offers free breast cancer screening for women, but forces men to pay for the best test to screen for prostate cancer.

“Why do men in Ontario have to pay for the PSA test for prostate cancer when the government in eight of the other 10 provinces pay for this screening tool?” a page on the Prostate Cancer Canada website asks.

“The PSA test can allow for the early detection of prostate cancer. But the Ontario government does not pay for it, leaving men in this province to foot the bill themselves,” the Prostate Cancer Canada comment continues. “In eight other provinces, the test is paid for. Why do men in Ontario not have equal access to a cancer test that could save lives? Act now to support fair and equal access to PSA tests for Ontarians.”

To “act now” people are asked to use a one-click tool to ask local election candidates to support free PSA tests for Ontario men. An Ontario election is slated for June 7. 

Could this become a provincial election issue? It’s highly doubtful. But it could lead to a further examination of the discrimination men face in determining their risk for prostate cancer. Now a prostate cancer screening test costs just $30 in Ontario. That’s not a lot of money to get screened for cancer. 

But at the same time, why are men paying anything for cancer screening when women get it for free?

Now there are two circumstances in which men can get a free PSA test in Ontario:

• A man’s physician or nurse practitioner suspects prostate cancer because of family history, race and/or the results of his physical examination (including digital rectal examination). Family history means one or two first degree relatives, such as father or brother.

• A man has been diagnosed with, or is receiving treatment for, or is being followed after treatment for, prostate cancer.

But the real question is why do men have to satisfy any pre-conditions to get screened for a cancer that kills in almost equal numbers to breast cancer, where screening is free?

That’s a question the government’s website answers this way in instructions to its doctors and nurse practitioners: “As screening authorities recommend against routine PSA testing for men without symptoms, your patients will rely on you to help them decide if the risks outweigh the benefits. To help facilitate a discussion, keep this reference material on hand when counselling patients about prostate cancer and PSA testing.”

In other words, try to talk your male patients out of getting the testing and save your provincial government some money.

Back in 2014, during the last provincial election campaign, The Toronto Star’s Julian Sher wrote about the controversy. The reporter spoke to Prostate Cancer Canada about the confusing government policy on funding the PSA test.

“It’s the best early detection tool there is,” said Rebecca von Goetz, Executive Vice President of Prostate Cancer Canada, which is pushing for a unified approach to testing across the country. “It’s our red flag.”

Von Goetz met with Ontario Health Minister Deb Matthews back in 2014 “to put prostate cancer on her radar.”

But Matthews told The Toronto Star at the time, she defended her government’s policies.

“We think it is important that we rely on evidence so that we put our precious dollars where they will have the greatest impact,” she said. “There just isn’t conclusive evidence that general screening for prostate cancer reduces illness or death.”

The Star opinion piece read: “There are some men for whom $30 to $50 for a PSA test is a financial hardship. When compared to a list of essential items, it’s likely the first thing to be cut.

“To put it into perspective, mammograms to screen for breast cancer, at a cost of about $85, are covered in every province. Both cancers affect comparable numbers of people: nearly 24,000 Canadian men were diagnosed with prostate cancer in 2013, about the same number of women diagnosed with breast cancer. That works out to one in seven men affected by prostate cancer in their lifetime, compared with one in nine women touched by breast cancer. Prostate and breast cancer kill similar numbers of Canadians each year (4,000 and 5,100 respectively).

“But this isn’t about gender equality. It’s about provincial equality for a test that can save lives,” The Toronto Star editorial continues. “Why are men in Ontario footing the bill for a test that’s covered by medicare in eight other provinces?”

The Canadian Cancer Survivor Network asked this question to each of the political parties during the 2014 Ontario election campaign: “Is your party in favour of implementing free PSA testing for prostate cancer in Ontario as a population-wide screening tool? If not, please explain how your party would ensure that Ontario men will have access to early diagnosis of prostate cancer.”

Nothing happened after that question was raised.

So what’s happening in the 2018 provincial election campaign in the quest for free prostate cancer screening for men? Not a thing appears on the radar yet. It appears this is one issue that will be swept into a dark corner once again as the government continues to look at cost-cutting measures to bail itself out of a debt that is now over $300 billion.

Emmy Skylar

Emmy Skylar started working for Debate Report in 2017. Emmy grew up in a small town in northern Manitoba. But moved to Ontario for university. Before joining Debate Report, Emmy briefly worked as a freelance journalist for CBC News.  She covers politics and the economy.

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