You have accessJournal of UrologyProstate Cancer: Detection & Screening V1 Apr 2017PD40-05 DETERMINANTS OF DEFAULT FROM FOLLOW-UP CARE IN A PROSTATE CANCER SCREENING PROGRAM Mark Ferretti, Michael Goltzman, Akhil Saji, Neel Patel, Denton Allman, Sean Fullerton, Gerald Matthews, and John Phillips Mark FerrettiMark Ferretti More articles by this author , Michael GoltzmanMichael Goltzman More articles by this author , Akhil SajiAkhil Saji More articles by this author , Neel PatelNeel Patel More articles by this author , Denton AllmanDenton Allman More articles by this author , Sean FullertonSean Fullerton More articles by this author , Gerald MatthewsGerald Matthews More articles by this author , and John PhillipsJohn Phillips More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1745AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The curability of high-risk prostate cancer (PCa) may depend on early diagnosis and compliance with management modalities. Delayed or incomplete treatment for PCa may result in inferior clinical outcomes and lower survival rates. We sought to identify the proportion of and predictors of loss of follow-up care after positive prostate biopsy in a single-institution, retrospective cohort study METHODS Patients who did not follow up for or so-called ‘defaulted’ treatment were defined as those who had failed to return for treatment or follow-up discussion after diagnosis of PCa. This did not include patients who elected to be treated at other hospitals. Demographic and clinical characteristics, were compared between defaulters and non-defaulters. A multiple linear regression was performed to predict those individuals likely to default. RESULTS From October 2008 to April 2013, 6182 patients received 12,930 PSA tests at a single institution. Of these patients, 574 (9%) patients had at least one PSA test level greater than 4 ng/mL. A total of 210 patients had subsequent biopsy, of which 141 had a PSA test >4 ng/mL. PCa was detected in 85 (41%) patients, of which 17 (20%) patients failed to follow up. The majority (88%) of defaulters were made aware of their biopsy results prior to self-cessation of care. Defaulters were significantly younger (61.8 ± 2.0y) at time of biopsy compared to non-defaulters (65.8 ± 1.0y), t(83) = 1.8, p = 0.04. Those individuals with an unspecified primary care provider (65%) were more likely to default than those who had primary care doctor at our institution (p<.001). Defaulters were more likely to be uninsured (24%) as compared to those with continued care (4%) (p=.01). Defaulters were more likely to self-identify as Latino (41%) as compared to those with continued care (9%) (p=.01). A multiple regression predicted default from age, insurance status, race and PCP access, p < .0005, R2 = .430. CONCLUSIONS At our institution men at highest risk of being lost to follow-up after the diagnosis of prostate cancer were younger, uninsured, Latino, and without centralized care. In our cohort, defaulters had high-risk disease (81% of Gleason >=7), which is crucial to identify in a timely and aggressive fashion so as to prevent future treatment failure. Development of strategies to encourage prompt and continued attendance is needed in addition to qualitative research to better understand the reasons for default and underpinning risk factors. © 2017FiguresReferencesRelatedDetailsCited byDai J, Ahn J, Holt S, May P, Sorensen M and Harper J (2018) National Imaging Trends after Percutaneous NephrolithotomyJournal of Urology, VOL. 200, NO. 1, (147-153), Online publication date: 1-Jul-2018. Volume 197Issue 4SApril 2017Page: e751-e752 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Mark Ferretti More articles by this author Michael Goltzman More articles by this author Akhil Saji More articles by this author Neel Patel More articles by this author Denton Allman More articles by this author Sean Fullerton More articles by this author Gerald Matthews More articles by this author John Phillips More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...