CONTEXT: Authorities discourage prostate screening in men who are likely to die from causes other than prostate cancer. PRACTICE PATTERN EXAMINED: Use of prostate biopsy-a proxy for screening-in men aged 65 and older with limited life expectancy (i.e., estimated to be less than 10 years). DATA SOURCE: Five percent samples of Part A (hospital) and Part B (physician) Medicare claims for 1993 through 1997. RESULTS: 22% of all Medicare beneficiaries who underwent a prostate biopsy had a limited life expectancy, corresponding to a rate of 1420 biopsies per 100,000. This rate did not change significantly between 1993 and 1997. For men with a life expectancy greater than 10 years, the biopsy rate was 2,360 per 100,000. Among men with limited life expectancy, in the year following the biopsy, 1.6% had radical prostatectomy and 2.3% had external-beam radiation. Thirty-nine percent were hospitalized. CONCLUSION: A substantial proportion of prostate biopsies are being performed in men with a life expectancy of less than 10 years. These men are unlikely to benefit from the biopsy or subsequent treatment.
CONTEXT: Authorities discourage prostate screening in men who are likely to die from causes other than prostate cancer. PRACTICE PATTERN EXAMINED: Use of prostate biopsy-a proxy for screening-in men aged 65 and older with limited life expectancy (i.e., estimated to be less than 10 years). DATA SOURCE: Five percent samples of Part A (hospital) and Part B (physician) Medicare claims for 1993 through 1997. RESULTS: 22% of all Medicare beneficiaries who underwent a prostate biopsy had a limited life expectancy, corresponding to a rate of 1420 biopsies per 100,000. This rate did not change significantly between 1993 and 1997. For men with a life expectancy greater than 10 years, the biopsy rate was 2,360 per 100,000. Among men with limited life expectancy, in the year following the biopsy, 1.6% had radical prostatectomy and 2.3% had external-beam radiation. Thirty-nine percent were hospitalized. CONCLUSION: A substantial proportion of prostate biopsies are being performed in men with a life expectancy of less than 10 years. These men are unlikely to benefit from the biopsy or subsequent treatment.