Use of prostate‐specific antigen testing as a disease surveillance tool following radical prostatectomy. Issue 19 (24th July 2013)

• Record Type: Journal Article
• Authors: Trantham, Laurel Clayton; Nielsen, Matthew E.; Mobley, Lee R.; Wheeler, Stephanie B.; Carpenter, William R.; Biddle, Andrea K.
• Is Part Of: Cancer. Volume 119:Issue 19(2013)
• Page Start: 3523
• Page End: 3530
• Publication Date: 2013-07-24
• Subjects: prostatic neoplasms -- prostate‐specific antigen -- practice guidelines as topic -- prostatectomy -- population surveillance; Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.28238
• Languages: English
• ISSNs: 0008-543X

Abstract

Abstract : BACKGROUND: Prostate‐specific antigen (PSA) testing is recommended every 6 to 12 months for the first 5 years following radical prostatectomy as a means to detect potential disease recurrence. Despite substantial research on factors affecting treatment decisions, recurrence, and mortality, little is known about whether men receive guideline‐concordant surveillance testing or whether receipt varies by year of diagnosis, time since treatment, or other individual characteristics. METHODS: Surveillance testing following radical prostatectomy among elderly men was examined using Surveillance, Epidemiology, and End Results cancer registry data linked to Medicare claims. Multivariate logistic regression was used to examine the effect of demographic, tumor, and county‐level characteristics on the odds of receiving surveillance testing within a given 1‐year period following treatment. RESULTS: Overall, receipt of surveillance testing was high, with 96% of men receiving at least one test the first year after treatment and approximately 80% receiving at least one test in the fifth year after treatment. Odds of not receiving a test declined with time since treatment. Nonmarried men, men with less‐advanced disease, and non‐Hispanic blacks and Hispanics had higher odds of not receiving a surveillance test. Year of diagnosis did not affect the receipt of surveillance tests. CONCLUSIONS: Most men receive guideline‐concordant surveillance PSA testing after prostatectomy, although evidence of a racial disparity between non‐Hispanic whites and some minority groups exists. The decline in surveillance over time suggests the need for well‐designed long‐term surveillance plans following radical prostatectomy. Cancer 2013;119:3523–3530. . © 2013 American Cancer Society . Abstract : Existing research on prostate cancer treatment decisions, recurrence, and mortality does not indicate whether men receive surveillance testing according to recommendations or whether receipt varies by time since treatment or individual characteristics. This study found that most men received guideline‐concordant prostate‐specific antigen surveillance testing after prostatectomy, although there is evidence that testing rates decrease as time from treatment increases.