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Changes observed in prostate biopsy practices in an inner city hospital with a high risk patient population following the 2012 USPSTF PSA screening recommendations
Tam, Andrew W; Khusid, Johnathan A; Inoyatov, Igor; Becerra, Adan Z; Davila, Jonathan; Chouhan, Jyoti D; Weiss, Jeffrey P; Hyacinthe, Llewellyn M; McNeil, Brian K; Winer, Andrew G.
Afiliação
  • Tam, Andrew W; University Hospital of Brooklyn. State University of New York Downstate College of Medicine. Department of Urology. Brooklyn. US
  • Khusid, Johnathan A; University Hospital of Brooklyn. State University of New York Downstate College of Medicine. Department of Urology. Brooklyn. US
  • Inoyatov, Igor; University Hospital of Brooklyn. State University of New York Downstate College of Medicine. Department of Urology. Brooklyn. US
  • Becerra, Adan Z; University of Rochester Medical Center. Department of Public Health Sciences and Division of Epidemiology. Rochester. US
  • Davila, Jonathan; University Hospital of Brooklyn. State University of New York Downstate College of Medicine. Department of Urology. Brooklyn. US
  • Chouhan, Jyoti D; University Hospital of Brooklyn. State University of New York Downstate College of Medicine. Department of Urology. Brooklyn. US
  • Weiss, Jeffrey P; University Hospital of Brooklyn. State University of New York Downstate College of Medicine. Department of Urology. Brooklyn. US
  • Hyacinthe, Llewellyn M; University Hospital of Brooklyn. State University of New York Downstate College of Medicine. Department of Urology. Brooklyn. US
  • McNeil, Brian K; University Hospital of Brooklyn. State University of New York Downstate College of Medicine. Department of Urology. Brooklyn. US
  • Winer, Andrew G; University Hospital of Brooklyn. State University of New York Downstate College of Medicine. Department of Urology. Brooklyn. US
Int. braz. j. urol ; 44(4): 697-703, July-Aug. 2018. tab
Artigo em Inglês | LILACS | ID: biblio-954078
Biblioteca responsável: BR1.1
ABSTRACT
ABSTRACT

Introduction:

We compared characteristics of patients undergoing prostate biopsy in a high-risk inner city population before and after the 2012 USPSTF recommendation against PSA based prostate cancer screening to determine its effect on prostate biopsy practices. Materials and

Methods:

This was a retrospective study including patients who received biopsies after an abnormal PSA measurement from October 2008-December 2015. Patients with previously diagnosed prostate cancer were excluded. Chi-square tests of independence, two sample t-tests, Mann-Whitney U tests, and Fisher's exact tests were performed.

Results:

There were 202 and 208 patients in the pre-USPSTF and post-USPSTF recommendation cohorts, respectively. The post-USPSTF cohort had higher median PSA (7.8 versus 7.1ng/mL, p=0.05), greater proportion of patients who were black (96.6% versus 90.5%, p=0.01), and greater percentage of biopsy cores positive for disease (58% versus 29.5%, p<0.001). Multivariable analysis supported that the increase in PSA was independent of the increase in the proportion of patients who were black. The proportion of patients who were classified as D'Amico intermediate and high-risk disease increased in the post-USPSTF cohort and approached statistical significance (70.1% versus 58.8%, p=0.12).

Conclusions:

Our study suggests that the USPSTF recommendations may have led to an increase in pre-biopsy PSA as well as greater volume of disease. Also, a greater proportion of patients were being classified with intermediate or high risk disease. While the clinical significance of these findings is unknown, what the data suggests is somewhat troubling. Future research should further examine these changes in a larger cohort as well as resultant long-term outcomes.
Assuntos


Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: LILACS Assunto principal: Neoplasias da Próstata / Antígeno Prostático Específico / Guias de Prática Clínica como Assunto / Medição de Risco / Biópsia Guiada por Imagem Tipo de estudo: Estudo diagnóstico / Estudo de etiologia / Guia de prática clínica / Estudo observacional / Fatores de risco / Estudo de rastreamento Limite: Idoso / Humanos / Masculino Idioma: Inglês Revista: Int. braz. j. urol Assunto da revista: Urologia Ano de publicação: 2018 Tipo de documento: Artigo País de afiliação: Estados Unidos Instituição/País de afiliação: University Hospital of Brooklyn/US / University of Rochester Medical Center/US

Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: LILACS Assunto principal: Neoplasias da Próstata / Antígeno Prostático Específico / Guias de Prática Clínica como Assunto / Medição de Risco / Biópsia Guiada por Imagem Tipo de estudo: Estudo diagnóstico / Estudo de etiologia / Guia de prática clínica / Estudo observacional / Fatores de risco / Estudo de rastreamento Limite: Idoso / Humanos / Masculino Idioma: Inglês Revista: Int. braz. j. urol Assunto da revista: Urologia Ano de publicação: 2018 Tipo de documento: Artigo País de afiliação: Estados Unidos Instituição/País de afiliação: University Hospital of Brooklyn/US / University of Rochester Medical Center/US
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