MP11-03 DECLINING RATES OF PROSTATE BIOPSY IN THE VETERANS HEALTH ADMINISTRATION IN THE PAST DECADE: AN ALTERNATE APPROACH TO LIMITING OVERDIAGNOSIS AND OVERTREATMENT OF PROSTATE CANCER?

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness II1 Apr 2014MP11-03 DECLINING RATES OF PROSTATE BIOPSY IN THE VETERANS HEALTH ADMINISTRATION IN THE PAST DECADE: AN ALTERNATE APPROACH TO LIMITING OVERDIAGNOSIS AND OVERTREATMENT OF PROSTATE CANCER? Gowtham Rao, K. Sue Haddock, and Sandip Prasad Gowtham RaoGowtham Rao More articles by this author , K. Sue HaddockK. Sue Haddock More articles by this author , and Sandip PrasadSandip Prasad More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.418AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES With increasing recognition of overdiagnosis and overtreatment of prostate cancer, increasing exposure has been placed on limiting prostate-specific antigen (PSA) testing for prostate cancer screening. An additional (but underexamined) intervention point to discourage prostate cancer screening is limiting the use of prostate biopsy by urologists. We analyzed the patterns of utilization of prostate biopsy across the Veterans Health Administration (VHA) in the past decade. METHODS Men aged between 40 and 80 years with at least one PSA value between 2003 and 2012 were included for analysis. Once men were biopsied, they were subsequently removed from the eligible study population, creating a dynamic cohort of over 250,000 men per year. An autoregressive, ecological parametric model was created to demonstrate trends for prostate biopsy, focusing on differences by race and age. RESULTS The rate of prostate biopsy in the VHA has declined annually over the past decade (p<0.001). Non-African American men and those over age 60 years had the most precipitous decline in the rate of prostate biopsy, while African American men and veterans under 60 years of age have not experienced the same change (p<0.001 for all groups). CONCLUSIONS Overall rates of prostate biopsy across the VHA have declined in all cohorts over the past decade. Biopsies in men at perceived higher risk (African American race) or with greater benefit from screening (younger age) have a lower rate of decline than the rest of the veteran population. Further research is needed to determine if these changes are a result of decreased PSA screening or more judicious use of prostate biopsy. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e96 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Gowtham Rao More articles by this author K. Sue Haddock More articles by this author Sandip Prasad More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...