Prostate Needle Biopsy Outcomes in the Era of the U.S. Preventive Services Task Force Recommendation Against PSA-Based Screening.

To determine whether the characteristics of patients undergoing prostate needle biopsies (PNBs) and PNB results have changed following the U.S. Preventive Services Task Force (USPSTF) recommendation in 2012 against prostate-specific antigen (PSA)-based screening for prostate cancer (PCa) for men of any age.

A prospective database of patients undergoing PNB at Virginia Mason from 2004 to 2014 was reviewed Welch's t-test and Chi-square tests were used to compare patients seen prior to those seen after the USPSTF recommendation.  Relative risks and corresponding confidence intervals (CI) were estimated by general linear regression.

Post-USPSTF patients (n=310) had higher PSA levels (p<0.001), were more likely to be diagnosed with higher clinical stage (2b, p=0.003; 2c-3a. p=0.027), and D'Amico high-risk PCa (p=0.036), with an adjusted relative risk (RR) for high-risk PCa of 1.25 (95% CI: 1.02-1.52) compared to pre-USPSTF patients (n=1,416). Limiting the pre-USPSTF group to the 30 months prior to the draft guidelines (n=448) yielded similar results. The absolute number of biopsies performed decreased by 31%, with the majority of the decrease occurring in the detection of intermediate-risk tumors.

In the two and a half years following the USPSTF recommendation against PSA-based screening, patients undergoing PNB were significantly more likely to be diagnosed with high-risk disease. However, reduction in the number of PNBs performed occurred concomitantly with a decrease in detection of intermediate-risk, potentially curable PCa. Future focus on informed application of screening techniques may prevent reversal of decades of improvement in prostate cancer mortality rate.

The Journal of Urology 2015 Aug 05 [Epub ahead of print]

John S Banerji, Erika M Wolff, John D Massman, Katherine Odem-Davis, Christopher R Porter, John M Corman

Virginia Mason, Section of Urology, Seattle, WA , Virginia Mason, Section of Urology, Seattle, WA , Virginia Mason, Section of Urology, Seattle, WA , Center for Biomedical Statistics, University of Washington, Seattle, WA , Virginia Mason, Section of Urology, Seattle, WA , Virginia Mason, Section of Urology, Seattle, WA

PubMed

E-Newsletters

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.

Subscribe