Histologic Changes in Prostate Cancer Detected Subsequent to the 2012 United States Preventive Services Task Force (USPSTF) Prostate Cancer Screening Recommendation

Reviews in Urology

Kamlesh K. Yadav¹  Carl A. Olsson²  Hugh J. Lavery³ 

[1] Columbia University Medical Center, New York, NY;Department of Urology, Icahn School of Medicine at Mount Sinai, Elmhurst, NY;Integrated Medical Professionals, PLLC, Melville, NY

关键词: Prostate cancer;    histopathology;    Prostate cancer screening;    Prostate cancer;    grade migration;   

DOI  :  10.3909/riu0815

学科分类：基础医学

来源: MedReviews, LLC

【 摘 要 】

We report changes in the histopathology of prostate cancer diagnosed in a large urology group practice after the final United States Preventive Services Task Force (USPSTF) Grade D recommendation against prostate-specific antigen screening. All prostate biopsies performed from 2011 through 2015 in a large urology group practice were retrospectively reviewed; 2012 was excluded as a transition year. The changes in biopsy data in years following the USPSTF decision (2013-2015) were then compared with baseline (2011). A total of 10,944 biopsies were evaluated during the study period. Positive biopsy rates rose from 39.1% at baseline to 45.2% in 2015 (P < 0.01) with a marked shift toward more aggressive cancer throughout the study period. The absolute number of patients presenting with Gleason Grade Group 4 or 5 increased from 155/year at baseline to 231, 297, and 285 in 2013, 2014, and 2015, respectively (P < 0.05), unrelated to age or racial changes over time. Black men represented 16% of the cohort. Since the USPSTF recommendation against prostate cancer screening, trends toward a substantial upward grade migration and increased volume of cancers were noted in a cohort of nearly 11,000 patients in a real-world clinical practice. Additionally, continuing reductions in cancer detection in the United States may exacerbate these trends.

【 授权许可】

Unknown