You have accessJournal of UrologyCME1 May 2022MP53-11 FOUR KALLIKREIN PANEL TESTING AMONG MEDICARE BENEFICIARIES UNDERGOING PROSTATE CANCER SCREENING Michael Leapman, Jessica Long, Rong Wang, Preston Sprenkle, Xiaomei Ma, and Cary Gross Michael LeapmanMichael Leapman More articles by this author , Jessica LongJessica Long More articles by this author , Rong WangRong Wang More articles by this author , Preston SprenklePreston Sprenkle More articles by this author , Xiaomei MaXiaomei Ma More articles by this author , and Cary GrossCary Gross More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002628.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate-specific antigen (PSA) isoforms, including a panel of four kallikrein markers, improve the prediction of high-grade prostate cancer in clinical studies and may potentially mitigate biopsy after prostate cancer screening. We evaluated determinants of real-world use of a commercially available four kallikrein marker panel (4Kscore®), and subsequent use of prostate biopsy among tested patients. METHODS: We queried the linked Surveillance, Epidemiology and End-Results Medicare database to identify a cohort of patients without a diagnosis of prostate cancer at the time of PSA testing in 1/2016-6/2019. Among patients receiving PSA screening, we evaluated clinical and sociodemographic factors associated with subsequent 4Kscore testing using descriptive statistics and multivariable generalized estimating equation models accounting for both sample weighting and repeated PSA testing events within patients. We compared the use of prostate biopsy and prostate cancer detection among 4Kscore tested versus untested patients. RESULTS: We identified a weighted sample of 3,892,492 PSA testing events, of which 10,195 were followed by 4Kscore testing (0.26%) within six months. The majority (97%) of 4Kscore tests were associated with an elevated PSA diagnosis. Beneficiaries who received 4Kscore testing were younger compared with those who did not undergo 4Kscore testing (mean 72.4 versus 74.2 years, p<0.001). In multivariable analysis, older age (odds ration [OR] = 0.13, 95% confidence interval [CI]: 0.08-0.21 for age 80+ versus 66-69 years), dual Medicaid eligibility (OR=0.61, 95% CI: 0.41-0.92), residence in higher poverty level zip codes (OR=0.55, 95% CI: 0.40-0.76 for ≥20% poverty vs <5%), and more comorbidities (OR=0.74, 95% CI: 0.62-0.90 for 1-2 versus 0 comorbidities) were associated with lower odds of 4Kscore testing. Within 6-months of PSA screening, 31% of patients who received 4Kscore testing (31%) underwent a prostate biopsy. This study is limited by absence of PSA values and clinical findings, which may influence the decision for both 4Kscore testing and biopsy. CONCLUSIONS: 4Kscore testing was used in a small proportion of older Americans screened for prostate cancer. In this setting, most patients undergoing 4Kscore testing for an elevated PSA did not undergo a subsequent prostate biopsy. Source of Funding: William O. Seery Foundation, Patterson Trust Research Award © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e899 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Leapman More articles by this author Jessica Long More articles by this author Rong Wang More articles by this author Preston Sprenkle More articles by this author Xiaomei Ma More articles by this author Cary Gross More articles by this author Expand All Advertisement PDF DownloadLoading ...