MP43-02 VARIATION IN USE OF CONFIRMATORY TESTING AMONG ACTIVE SURVEILLANCE CANDIDATES

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance II1 Apr 2017MP43-02 VARIATION IN USE OF CONFIRMATORY TESTING AMONG ACTIVE SURVEILLANCE CANDIDATES Gregory Auffenberg, Zaojun Ye, Brian Lane, Susan Linsell, Nikola Rakic, Andrew Brachulis, Michael Cher, David Miller, and Michigan Urological Surgery Improvement Collaborative Gregory AuffenbergGregory Auffenberg More articles by this author , Zaojun YeZaojun Ye More articles by this author , Brian LaneBrian Lane More articles by this author , Susan LinsellSusan Linsell More articles by this author , Nikola RakicNikola Rakic More articles by this author , Andrew BrachulisAndrew Brachulis More articles by this author , Michael CherMichael Cher More articles by this author , David MillerDavid Miller More articles by this author , and Michigan Urological Surgery Improvement Collaborative More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1312AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recognizing the importance of fully characterizing cancer severity prior to Active Surveillance (AS), many advocate for confirmatory testing (e.g., repeat biopsy, MRI) shortly after prostate cancer (CaP) diagnosis. In this context, we examined utilization of such testing among AS eligible men across urology practices in Michigan. METHODS The Michigan Urological Surgery Improvement Collaborative (MUSIC) is a consortium of 43 urology practices. We identified all men with newly-diagnosed CaP entered into the collaborative′s registry from January 2012 through April 2016 that met MUSIC′s published AS appropriateness criteria (i.e., age < 80, any Gleason Score ≤6 or Gleason Score 3+4 with ≤3 positive cores and no more than 50% of any core involved). Among men with sufficient follow-up, we first calculated the proportion that received a confirmatory test (defined as receipt of a repeat prostate biopsy or prostate MRI) within 6 months and 12 months after diagnosis, respectively. For practices with at least 10 AS eligible patients, we then assessed practice-level variation in the rates of confirmatory testing. Finally, we fit regression models to identify characteristics associated with receipt of a confirmatory test. RESULTS During this time period, 434/5,292 (7.6 %) and 695/4,614 (15.1%) eligible men received confirmatory testing within 6 and 12 months of diagnosis, respectively. At a practice level, rates of confirmatory testing varied widely for both the 6- (0 % to 27.5%; p<0.001) and 12-month intervals (0 % to 60.0%; p<0.001) (Figure). Patients with GS 3+4 tumors and PSA levels > 4 were less likely to undergo confirmatory testing, while such tests were more frequent among patients diagnosed more recently and in larger practices (Table). CONCLUSIONS Although increasing over time, utilization of repeat biopsy or prostate MRI to confirm risk stratification among men who are candidates for AS has been uncommon and highly variable across urology practices. These data have prompted ongoing efforts in MUSIC to increase and standardize use of such tests among men considering AS. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e553 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Gregory Auffenberg More articles by this author Zaojun Ye More articles by this author Brian Lane More articles by this author Susan Linsell More articles by this author Nikola Rakic More articles by this author Andrew Brachulis More articles by this author Michael Cher More articles by this author David Miller More articles by this author Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...