The rates of prostate biopsy and radical prostatectomy have decreased significantly since the US Preventive Services Task Force (USPSTF) issued its 2012 recommendation against prostate-specific antigen (PSA) screening, according to a study published in JAMA Surgery.1
Studies have demonstrated that use of PSA screening decreased following the USPSTF 2012 recommendation; however, its effect on practice patterns in the prostate cancer diagnosis and treatment remain unclear.
To evaluate the volumes of prostate biopsy and radical prostatectomy, investigators analyzed data from a sample of urologists across practice settings and a nationally representative sample of all radical prostatectomy discharges. A total of 5173 urologists performed at least 1 prostate biopsy and 3748 performed at least 1 radical prostatectomy.
Results showed that following the USPSTF 2012 recommendation, median biopsy volume per urologist decreased from 29 to 21 (P <.001).
Researchers also found that biopsy volume decreased by 28.7% after 2012 (P <.001). Similarly, median prostatectomy volume per urologist decreased from 7 to 6 (P <.001) following the USPSTF recommendation, corresponding to a 16.2% reduction in radical prostatectomy volume (P =.003).
Of note, researchers observed regional variation in radical prostatectomy volume, with urologists in New England performing the fewest number of radical prostatectomies and those in the North Central United States performing the most.
Despite these findings, further evaluation is needed to fully assess the long-term impact of the 2012 USPSTF recommendation with respect to stage at presentation, outcomes following treatment, and disease-specific mortality in patients with prostate cancer.
1. Halpern JA, Shoag JE, Artis AS, et al. National trends in prostate biopsy and radical prostatectomy volumes following the United States Preventative Services Task Force guidelines against prostate-specific antigen screening. JAMA Surg. 2016 Nov 2. doi: 10.1001/jamasurg.2016.3987. [Epub ahead of print]