PD38-04 IMPACT OF USING THE PROSTATE BIOPSY COLLABORATE GROUP RISK CALCULATOR TO INFORM UROLOGY REFERRAL FOR PROSTATE CANCER RISK

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening III (PD38)1 Apr 2020PD38-04 IMPACT OF USING THE PROSTATE BIOPSY COLLABORATE GROUP RISK CALCULATOR TO INFORM UROLOGY REFERRAL FOR PROSTATE CANCER RISK James Kearns*, William Anderson, Timothy Hetherington, Earle Burgess, Stephen Riggs, Jason Zhu, Peter Clark, and Kris Gaston James Kearns*James Kearns* More articles by this author , William AndersonWilliam Anderson More articles by this author , Timothy HetheringtonTimothy Hetherington More articles by this author , Earle BurgessEarle Burgess More articles by this author , Stephen RiggsStephen Riggs More articles by this author , Jason ZhuJason Zhu More articles by this author , Peter ClarkPeter Clark More articles by this author , and Kris GastonKris Gaston More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000917.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The use of a validated risk calculator, such as the Prostate Biopsy Collaborative Group Risk Calculator (PBCGRC), may assist primary care providers in determining which patients to refer to urology for PCa risk. Our objectives were to determine whether retrospective application of the PBCGRC would result in more appropriate referral to urology for PCa risk, and to determine whether using a nomogram could potentially decrease racial disparities in urology referral. METHODS: This retrospective cohort study used data from the Atrium Health Enterprise Data Warehouse, which includes clinical records from over 900 care locations across North and South Carolina. Participants included 80,113 men aged ≥ 40 who were seen in the ambulatory or outpatient setting during 1/1/17 – 6/30/19 and had referral data. We used referral orders to determine whether a patient had been referred to urology for PCa risk (elevated PSA and/or abnormal prostate exam). Each man was assigned a PBCGRC risk of high-grade PCa (HGPCa) for each clinical encounter. Over-referrals were defined as patients with a HGPCa risk < 10% who were referred, and under-referrals were defined as patients with a HGPCa risk ≥ 10% who were not referred. Statistical significance was defined as p < 0.05. RESULTS: The average age of participants was 59.9 years, 14.8% were African American (AA), and 2.9% (n=2316) were referred to urology for PCa risk. 4.4% of AA men and 2.6% of Caucasian men were referred. Use of the PBCGRC would have changed overall referrals by 34% (p < 0.01) (see table). The proportion of under referred men was 35% for Caucasians, and 32% for African Americans (p < 0.01). CONCLUSIONS: Using a validated risk calculator, such as the PBCGRC, to determine which men to refer to urology for prostate cancer risk could significantly improve prostate cancer screening by reducing inappropriate over and under referrals. Additionally, the use of the PBCGRC would have a greater impact upon referrals for Caucasian men as compared with AA men. Further study for how to incorporate risk calculator use into PCP workflows is warranted to improve referrals to urology for prostate cancer risk. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e802-e802 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information James Kearns* More articles by this author William Anderson More articles by this author Timothy Hetherington More articles by this author Earle Burgess More articles by this author Stephen Riggs More articles by this author Jason Zhu More articles by this author Peter Clark More articles by this author Kris Gaston More articles by this author Expand All Advertisement PDF downloadLoading ...