AUA 2019: Characterization of Factors Underlying Physician-Level Variation in the Use of Active Surveillance Among Men with Low Risk Prostate Cancer: Data From the Pennsylvania Urologic Regional Collaborative

Chicago, IL (UroToday.com) During the podium session on Prostate Cancer: Localized: Active Surveillance II at the Annual AUA 2019 meeting in Chicago, IL, Dr. Reese presented his talk on- Characterization of Factors Underlying Physician-Level Variation in the Use of Active Surveillance Among Men with Low-Risk Prostate Cancer: Data From the Pennsylvania Urologic Regional Collaborative (PURC). Prior studies have shown significant variation in the utilization of active surveillance (AS) amongst individual physicians managing patients with newly diagnosed low-risk prostate cancer. Dr. Reese and colleagues hypothesized that factors including physician age and number of years in practice, as well as the volume of patients managed by the physician, may influence AS rates.

Pennsylvania Urologic Regional Collaborative (PURC) database was utilized, which is a voluntary collaborative of urology practices in Pennsylvania and New Jersey, including men with low-risk prostate cancer as defined by the AUA. For each physician in PURC, they determined the percentage of low-risk patients managed with AS. Pearson correlation coefficient was used to determine associations of physician age, number of years in practice, and patient volume with AS utilization rates for each physician.

Dr. Reese then summarized the results of this study. AS rates by individual physician ranged from 10%-100% for men with low-risk prostate cancer, and 20%-100% for men with very low-risk disease. Trends were seen towards decreased use of AS with increasing physician age, number of years in practice, and patient volume, although these associations did not reach statistical significance.

AUA2019_Underlying Physician-Level Variation in AS .png

Dr. Reese concluded with a summary that patients with low-risk prostate cancer, physician-related factors may impact the adoption of AS. Observed trends toward a decreased use of AS was noted among physicians of older age, with a greater number of years in practice, and large patient volumes. These variables, however, explain only a small percentage of the significant variation in AS rates among individual practitioners. Additional study is therefore needed to better define the factors underlying AS variation and establishing guidelines for AS more uniformly and efficiently.

Presented by: Adam Reese, MD, Associate Professor, Urology Chief, Urologic Oncology, Temple University Hospital

Written by: Abhishek Srivastava, MD, Society of Urologic Oncology Fellow, Fox Chase Cancer Center, Fox Chase Cancer Center, Philadelphia, PA, Twitter: @shekabhishek at the American Urological Association's 2019 Annual Meeting (AUA 2019), May 3 – 6, 2019 in Chicago, Illinois

Login