Frequency of Post-Treatment PSA Surveillance in Localized Prostate Cancer: AFT-30, a National Study

Abstract

The optimal frequency of post-treatment PSA surveillance is unknown, and different existing guidelines based on expert opinions have widely varying recommendations. We assessed the frequencies of PSA surveillance following definitive treatment of localized prostate cancer, and factors associated with PSA surveillance frequency. Using the backbone of the National Cancer Data Base (NCDB), medical records of 10,475 randomly sampled patients diagnosed with localized prostate cancer from 2005-2010 were abstracted from 1007 sites throughout the United States to provide additional data for this study. PSA data were collected from each patient’s primary care provider, urologist, and radiation oncologist. Multivariable negative binomial regression was used to assess patient and tumor characteristics associated with frequency of PSA testing. Median age was 64 years and 72% were White. At diagnosis, 39% (N=4088), 31% (N=3240), and 30% (N=3147) of men had low, intermediate, and high-risk prostate cancer, respectively. Fifty-three percent of men underwent definitive radiotherapy, while 47% underwent radical prostatectomy. Median numbers of PSAs were 2 in the first year after treatment and 2 in year 2. Multivariable analysis showed that patients with low- and intermediate-risk disease had more frequent PSA surveillance than did high-risk patients in the first two years (Table). Further, White race and care at an academic center were associated with more frequent PSA surveillance. There are variations in frequency of PSA surveillance after definitive treatment based on patient factors and location of care. Research is needed to assess whether more frequent surveillance improves patient survival to inform future guidelines, which can hopefully reduce variations in practice (Support: PCORI CER-1503-29220).Abstract TU_9_2986; TableMultivariable negative binomial regression analysis*CoefficientPRisk group (REF: High) Low Intermediate. 0.030 0.041. 0.046 0.006Race (REF: Non-Hispanic White) Non-Hispanic Black Hispanic/Other/Unknown. -0.062 -0.0075. <0.001 0.646Facility type (REF: Integrated Network) Academic Community program Comprehensive community program. 0.13 0.021 0.027. <0.001 0.349 0.180*Model also adjusted for age, median income, census track education, urban/rural, and treatment modality Open table in a new tab