SUO 2017: Population-based Outcomes Of Men With A Single Negative Prostate Biopsy: Importance Of Continued Follow Up Among Older Patients
Methods: This was a retrospective population-based study, using data from linked health administrative databases, of all Ontario-based men with a negative first biopsy between January 1994 and October 2014. Patients were followed from time of first biopsy till death, administrative censoring, or end of study period. Cumulative incidence functions were used to calculate the study outcomes’ cumulative incidences.
Results: The total cohort included 95,675 men with a median age of 63.0 years. Median follow-up was 8.1 years. The 20-year cumulative rate of prostate cancer-specific mortality and diagnosis were 1.8% and 23.7%, respectively. Men aged 70-79 and 80-84 at initial biopsy had 20-year prostate cancer-specific mortality cumulative rates of 3.2% and 6.4% respectively. Among patients subsequently diagnosed with prostate cancer, 71.3%, 19.4%, and 8.3% were diagnosed after one, two, and three or more repeat biopsies. Higher socioeconomic status and urban residence were associated with higher diagnosis risks yet lower prostate cancer-specific mortality risks.
Conclusion: Following a negative first biopsy, 23.7% of men are subsequently diagnosed with and 1.8% die of prostate cancer within 20 years. Cancer-specific mortality rates were considerably worse in older men, suggesting the need for more aggressive treatment approaches in medically fit older individuals.
Presented by: Rashid Sayyid, Georgia, USA
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, @GoldbergHanan, at the 18th Annual Meeting of the Society of Urologic Oncology, November 29-December 1, 2017 – Washington, DC