PD13-02 TRENDS IN PROSTATE CANCER TREATMENT: DATA FROM THE MICHIGAN UROLOGIC SURGICAL IMPROVEMENT COLLABORATIVE

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History I (PD13)1 Apr 2020PD13-02 TRENDS IN PROSTATE CANCER TREATMENT: DATA FROM THE MICHIGAN UROLOGIC SURGICAL IMPROVEMENT COLLABORATIVE Richard C. Wu*, Ji Qi, Susan Linsell, Khurshid Ghani, James Montie, David C. Miller, Arvin George, Richard Sarle, and for the Michigan Urological Surgery Improvement Collaborative Richard C. Wu*Richard C. Wu* More articles by this author , Ji QiJi Qi More articles by this author , Susan LinsellSusan Linsell More articles by this author , Khurshid GhaniKhurshid Ghani More articles by this author , James MontieJames Montie More articles by this author , David C. MillerDavid C. Miller More articles by this author , Arvin GeorgeArvin George More articles by this author , Richard SarleRichard Sarle More articles by this author , and for the Michigan Urological Surgery Improvement Collaborative More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000847.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The Michigan Urological Surgery Improvement Collaborative (MUSIC) is a quality improvement program focused on improving the care of men with prostate cancer (CaP). Data collected from MUSIC to support quality improvement initiatives has helped shaped the CaP landscape in the state of Michigan. We aim to describe the evolving trends in the diagnosis and management of CaP within the collaborative. METHODS: MUSIC is a state-wide clinical consortium comprised of 45 diverse urology practices. The consortium maintains a prospective registry of men with CaP including patient demographic characteristics, disease severity, and treatment choice. Descriptive analytics were used to describe trends from 2012 to 2019. RESULTS: There are 33,000 prostate cancer patients in the registry among 45 practices. Median age and PSA at diagnosis increased from 2012 to 2019 (64 vs. 66) and (5.4 ng/ml vs. 6.6 ng/ml), respectively. We observed an increase in the positive biopsy rate, increasing from 58% in 2012 to 64% in 2018, and 61% in 2019. The proportion of GG1 diagnosed decreased from 34.4% to 27.4%, while ≥GG2 saw corresponding increase. Perhaps the most significant finding within the collaborative was the change in NCCN low risk CaP where surveillance increased from 46.6% to 89.2%. We also observed a decline in definitive treatment in the low risk patients, decreasing from 46.6% to 9.8%. A similar trend was found in intermediate risk CaP (Figures 1 and 2). The rate of metastatic disease at diagnosis remained unchanged (4.9 vs 4.7%). CONCLUSIONS: The diagnosis of ≥GG2 CaP has increased likely reflecting changes in screening and biopsy practice patterns. The utilization of active surveillance in MUSIC has increased to 89% as of 2019 representing one of the highest rates of AS for low risk CaP in the nation. Changes in practice likely reflect evolving guideline recommendations, novel biomarkers and imaging that improve CaP risk stratification, and considerable physician-directed quality improvement activities within MUSIC. Source of Funding: Blue Cross Blue Shield of Michigan © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e266-e266 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Richard C. Wu* More articles by this author Ji Qi More articles by this author Susan Linsell More articles by this author Khurshid Ghani More articles by this author James Montie More articles by this author David C. Miller More articles by this author Arvin George More articles by this author Richard Sarle More articles by this author for the Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement PDF downloadLoading ...