Joshua A Halpern1, Jonathan E Shoag1, Amanda S Artis2, Karla V Ballman2, Art Sedrakyan2, Dawn L Hershman3, Jason D Wright3, Ya Chen Tina Shih4, Jim C Hu1. 1. Department of Urology, Weill Cornell Medicine, New York, New York. 2. Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, New York. 3. Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, New York, New York. 4. Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston.
Abstract
Importance: Studies demonstrate that use of prostate-specific antigen screening decreased significantly following the US Preventive Services Task Force (USPSTF) recommendation against prostate-specific antigen screening in 2012. Objective: To determine downstream effects on practice patterns in prostate cancer diagnosis and treatment following the 2012 USPSTF recommendation. Design, Setting, and Participants: Procedural volumes of certifying and recertifying urologists from 2009 through 2016 were evaluated for variation in prostate biopsy and radical prostatectomy (RP) volume. Trends were confirmed using the New York Statewide Planning and Research Cooperative System and Nationwide Inpatient Sample. The study included a representative sample of urologists across practice settings and nationally representative sample of all RP discharges. We obtained operative case logs from the American Board of Urology and identified urologists performing at least 1 prostate biopsy (n = 5173) or RP (n = 3748), respectively. Exposures: The 2012 USPSTF recommendation against routine population-wide prostate-specific antigen screening. Main Outcomes and Measures: Change in median biopsy and RP volume per urologist and national procedural volume. Results: Following the USPSTF recommendation, median biopsy volume per urologist decreased from 29 to 21 (interquartile range [IQR}, 12-34; P < .001). After adjusting for physician and practice characteristics, biopsy volume decreased by 28.7% following 2012 (parameter estimate, -0.25; SE, 0.03; P < .001). Similarly, following the USPSTF recommendation, median RP volume per urologist decreased from 7 (IQR, 3-15) to 6 (IQR, 2-12) (P < .001), and in adjusted analyses, RP volume decreased 16.2% (parameter estimate, -0.15; SE, 0.05; P = .003). Conclusions and Relevance: Following the 2012 USPSTF recommendation, prostate biopsy and RP volumes decreased significantly. A panoramic vantage point is needed to evaluate the long-term consequences of the 2012 USPSTF recommendation.
Importance: Studies demonstrate that use of prostate-specific antigen screening decreased significantly following the US Preventive Services Task Force (USPSTF) recommendation against prostate-specific antigen screening in 2012. Objective: To determine downstream effects on practice patterns in prostate cancer diagnosis and treatment following the 2012 USPSTF recommendation. Design, Setting, and Participants: Procedural volumes of certifying and recertifying urologists from 2009 through 2016 were evaluated for variation in prostate biopsy and radical prostatectomy (RP) volume. Trends were confirmed using the New York Statewide Planning and Research Cooperative System and Nationwide Inpatient Sample. The study included a representative sample of urologists across practice settings and nationally representative sample of all RP discharges. We obtained operative case logs from the American Board of Urology and identified urologists performing at least 1 prostate biopsy (n = 5173) or RP (n = 3748), respectively. Exposures: The 2012 USPSTF recommendation against routine population-wide prostate-specific antigen screening. Main Outcomes and Measures: Change in median biopsy and RP volume per urologist and national procedural volume. Results: Following the USPSTF recommendation, median biopsy volume per urologist decreased from 29 to 21 (interquartile range [IQR}, 12-34; P < .001). After adjusting for physician and practice characteristics, biopsy volume decreased by 28.7% following 2012 (parameter estimate, -0.25; SE, 0.03; P < .001). Similarly, following the USPSTF recommendation, median RP volume per urologist decreased from 7 (IQR, 3-15) to 6 (IQR, 2-12) (P < .001), and in adjusted analyses, RP volume decreased 16.2% (parameter estimate, -0.15; SE, 0.05; P = .003). Conclusions and Relevance: Following the 2012 USPSTF recommendation, prostate biopsy and RP volumes decreased significantly. A panoramic vantage point is needed to evaluate the long-term consequences of the 2012 USPSTF recommendation.
Authors: Adrien N Bernstein; Jonathan E Shoag; Ron Golan; Joshua A Halpern; Edward M Schaeffer; Wei-Chun Hsu; Paul L Nguyen; Art Sedrakyan; Ronald C Chen; Scott E Eggener; Jim C Hu Journal: J Urol Date: 2017-12-26 Impact factor: 7.450
Authors: Carolyn A Salter; Phil Vu Bach; Eduardo Miranda; Lawrence C Jenkins; Nicole Benfante; Elizabeth Schofield; Christian J Nelson; John P Mulhall Journal: J Sex Med Date: 2020-01-21 Impact factor: 3.802