Prostate cancer testing following a negative prostate biopsy : Over testing the elderly

Richard M HOFFMAN; Thomas DENBERG; William C HUNT; Ann S HAMILTON

doi:10.1007/s11606-007-0248-7

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Prostate cancer testing following a negative prostate biopsy : Over testing the elderly

Journal article

Open access

Peer reviewed

Prostate cancer testing following a negative prostate biopsy : Over testing the elderly

Richard M HOFFMAN, Thomas DENBERG, William C HUNT and Ann S HAMILTON

Journal of general internal medicine : JGIM, Vol.22(8), pp.1139-1143

2007

DOI: 10.1007/s11606-007-0248-7

PMCID: PMC2305754

PMID: 17554589

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https://europepmc.org/articles/pmc2305754View

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Abstract

Background: Screening elderly men for prostate cancer is not recommended because definitive treatments are unlikely to extend life expectancy. Objective: Describe clinical outcomes after a negative prostate biopsy in a population-based cohort of men ages 65 and older. Design: Retrospective cohort study. Participants: 9,410 Medicare-eligible men who underwent a prostate biopsy in Los Angeles or New Mexico in 1992. Measurements: We used Medicare and SEER databases to identify a cohort with an initial negative biopsy (n = 7,119) and to ascertain survival, subsequent PSA testing, prostate biopsies, and prostate cancer detection and treatment through 1997. Results: The overall 5-year survival was 79.4% (95% CI 78.4-80.3), but only 74.6% (72.4-76.7) for men ages 75-79 at the time of the initial negative biopsy and 55.0% (51.9-57.9) for men ages 80+. During a median 4.5 years follow-up, a cumulative 75.0% (73.9-76.1) of the cohort underwent PSA testing. Among men ages 75-79 and 80+, the cumulative proportions that underwent PSA testing were 75.4% (73.0-77.8) and 74.3% (71.1-77.5), respectively. Additionally, 29.1% (26.7-31.6) of men ages 75-79 and 20.1% (17.6-23.1) of men ages 80+ underwent repeat prostate biopsy, and 10.9% (9.4-12.7) and 8.3% (6.6-10.4), respectively, were diagnosed with cancer. Among men ages 75+ with localized cancers, approximately 34% received definitive treatment. Conclusions: High proportions of men ages 75+ underwent PSA testing and repeat prostate biopsies after an initial negative prostate biopsy. Given the known harms and uncertain benefits for finding and treating localized cancer in elderly men, most continued PSA testing after a negative biopsy is potentially inappropriate.

Tumors of the urinary system

Urinary tract. Prostate gland

Public health. Hygiene-occupational medicine

Public health. Hygiene

General aspects

Miscellaneous

Nephrology. Urinary tract diseases

Biological and medical sciences

Medical sciences

Details

Title: Subtitle: Prostate cancer testing following a negative prostate biopsy : Over testing the elderly
Creators: Richard M HOFFMAN - Department of Medicine, New Mexico VA Health Care System, 111GIM 1501 San Pedro Drive SE, Albuquerque, New Mexico 87108, United States
Thomas DENBERG - Division of General Internal Medicine, Department of Medicine, University of Colorado at Denver and Health Sciences Center, Denver, Colorado, United States
William C HUNT - University of New Mexico Cancer Research and Treatment Center, Albuquerque, New Mexico, United States
Ann S HAMILTON - Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, United States
Resource Type: Journal article
Publication Details: Journal of general internal medicine : JGIM, Vol.22(8), pp.1139-1143
DOI: 10.1007/s11606-007-0248-7
PMID: 17554589
PMCID: PMC2305754
NLM abbreviation: J Gen Intern Med
ISSN: 0884-8734
eISSN: 1525-1497
Publisher: Springer
Language: English
Date published: 2007
Academic Unit: Epidemiology; General Internal Medicine; Internal Medicine
Record Identifier: 9984094663002771

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