Impact of Prostate-specific Antigen (PSA) Screening Trials and Revised PSA Screening Guidelines on Rates of Prostate Biopsy and Postbiopsy Complications

Boris Gershman, Holly K. Van Houten, Jeph Herrin, Daniel M. Moreira, Simon P. Kim, Nilay D Shah, Robert Jeffrey Karnes

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

Background: Prostate biopsy and postbiopsy complications represent important risks of prostate-specific antigen (PSA) screening. Although landmark randomized trials and updated guidelines have challenged routine PSA screening, it is unclear whether these publications have affected rates of biopsy or postbiopsy complications. Objective: To evaluate whether publication of the 2008 and 2012 US Preventive Services Task Force (USPSTF) recommendations, the 2009 European Randomized Study of Screening for Prostate Cancer and the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, or the 2013 American Urological Association (AUA) guidelines was associated with changes in rates of biopsy or postbiopsy complications, and to identify predictors of postbiopsy complications. Design, setting, and participants: This quasiexperimental study used administrative claims of 5. 279. 315 commercially insured US men aged ≥40 yr from 2005 to 2014, of whom 104. 584 underwent biopsy. Interventions: Publications on PSA screening. Outcome measurements and statistical analysis: Interrupted time-series analysis was used to evaluate the association of publications with rates of biopsy and 30-d complications. Logistic regression was performed to identify predictors of complications. Results and limitations: From 2005 to 2014, biopsy rates fell 33% from 64.1 to 42.8 per 100. 000 person-months, with immediate reductions following the 2008 USPSTF recommendations (-10.1; 95% confidence interval [CI], -17.1 to -3.0; p

Original languageEnglish (US)
JournalEuropean Urology
DOIs
StateAccepted/In press - 2016

Keywords

  • Complications
  • Guidelines
  • Prostate biopsy
  • PSA screening
  • Randomized trials

ASJC Scopus subject areas

  • Urology

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