BILL ANALYSIS �
AB 1621
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Date of Hearing: March 27, 2012
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Mary Hayashi, Chair
AB 1621 (Halderman) - As Introduced: February 8, 2012
SUBJECT : Physicians and surgeons: prostate cancer.
SUMMARY : Exempts physicians and surgeons working on trauma
cases from current law requiring that physicians and surgeons
provide specified information about prostate cancer diagnostic
procedures to patients who undergo an examination of the
prostate gland.
EXISTING LAW
1)Establishes the Grant H. Kenyon Prostate Cancer Detection Act,
which requires that, if a physician and surgeon, during a
physical examination, examines a patient's prostate gland, the
physician and surgeon provide information to the patient about
the availability of appropriate diagnostic procedures,
including, but not limited to, the prostate antigen (PSA)
test, if any of the following conditions are present:
a) The patient is over 50 years of age;
b) The patient manifests clinical symptomatology;
c) The patient is at an increased risk of prostate cancer;
or,
d) The provision of the information to the patient is
medically necessary, in the opinion of the physician and
surgeon.
2)Provides that violation of 1), above, constitutes
unprofessional conduct and is not subject to a misdemeanor
penalty.
3)Defines "trauma case" as any injured person who has been
evaluated by prehospital personnel according to policies and
procedures established by the local EMS agency, as specified,
and who has been found to require transportation to a trauma
facility.
AB 1621
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FISCAL EFFECT : Unknown. This bill has been keyed non-fiscal.
COMMENTS :
Purpose of this bill . According to the author, "Current law
requires that any time a doctor or surgeon performs a prostate
exam on a patient with certain risk factors, that the doctor or
surgeon must give that patient information about prostate
cancer?Usually, this is a beneficial provision which alerts men
to their potential risk for prostate cancer.
"However, doctors and surgeons are bound by this requirement
even in situations where it is impossible or impractical. In
certain situations, administering emergency care requires
performing a prostate exam. For example, an emergency room
doctor may check for internal trauma before catheterizing an
unconscious patient. By the time the patient is stable or
conscious, he may have been transported to a different unit or
to a different facility entirely. In this situation it may be
impossible or extremely time-consuming for the emergency room
doctor to track that patient down to give them this information.
Yet failing to do so puts that doctor in violation of the law,
and vulnerable to lawsuits."
Background .
It is estimated that there will be more than 241,700 new cases
of prostate cancer and approximately 28,170 deaths from prostate
cancer in the United States in 2012, according to the
National Cancer Institute (NCI), part of the National Institutes
of Health within the United States (U.S.) Department of Health
and Human Services.
The California Cancer Registry estimates more than 20,000 new
cases of prostate cancer in California in 2012, the highest
percentage of new cancer cases for men, at 28%. Estimated
deaths from prostate cancer in California in 2012 exceed 3,000.
Prostate cancer is one of the top four types of cancer for men
in California, regardless of race/ethnicity.
Prostate-specific antigen (PSA) is a protein produced by cells
of the prostate gland. The PSA test measures the level of PSA
in the blood. Doctors' recommendations for PSA screening vary.
The higher a man's PSA level, the more likely it is that cancer
AB 1621
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is present, but there are other possible reasons for an elevated
PSA level. The PSA test for screening has limitations and is
still controversial.
Current law requires doctors who examine a patient's prostate
gland to provide that patient with information about the
availability of diagnostic procedures, including PSA testing,
if: the patient is over 50; the patient manifests clinical
symptoms; the patient is at an increased risk for prostate
cancer; or, the doctor believes providing the information is
medically necessary. Physicians often meet this requirement by
providing patients with printed material such as a 59-page
booklet published by the NCI.
Emergency room doctors contend that current law can be
impractical and possibly misleading. Trauma patients can
require examination for internal injuries or placement of
medical equipment that triggers the prostate cancer notification
requirement. However, these patients are often unconscious at
the time, and can be transferred to another unit or another
facility before regaining consciousness. Tracking them down can
be onerous for the treating physician, and providing the
information can mislead the patient into thinking they are at
risk for prostate cancer when the examination was performed for
a completely different medical reason.
This bill exempts doctors working on trauma patients from the
prostate cancer notification requirement.
Previous legislation . SB 1 (Burton) Chapter 11, Statutes of
1997, establishes the Grant H. Kenyon Prostate Cancer Detection
Act, which requires physicians and surgeons to provide specified
information about prostate cancer diagnostic procedures to
patients who undergo an examination of the prostate gland.
REGISTERED SUPPORT / OPPOSITION :
Support
California Chapter of the American College of Emergency
Physicians
California Hospital Association
Northern California Chapter of the American College of Surgeons
One individual
AB 1621
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Opposition
None on file
Analysis Prepared by : Angela Mapp / B.,P. & C.P. / (916)
319-3301