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Published on: November 2, 2013
Prostate biopsies in men with limited life expectancy.
John H Wasson1, Thomas A Bubolz, Grace Lu Yao
1Center for the Aging, Dartmouth Medical School, Hanover, NH 03755-3862, USA. john.h.wasson@dartmouth.edu
Effective Clinical Practice : ECP
|June 29, 2002
Summary
Many older men with limited life expectancy undergo prostate biopsies, despite guidelines discouraging screening for those unlikely to benefit. This practice remained unchanged from 1993-1997, indicating a need for improved adherence to recommendations.
Area of Science:
- Geriatric Medicine
- Urology
- Health Services Research
Background:
- Official recommendations advise against prostate cancer screening in men with limited life expectancy.
- Prostate biopsy is used as a proxy for screening in this study.
Purpose of the Study:
- To examine the practice patterns of prostate biopsy in older men with limited life expectancy.
- To assess the rate of prostate biopsies in men aged 65+ with a life expectancy under 10 years.
Main Methods:
- Analysis of 5% Medicare claims data (Parts A and B) from 1993-1997.
- Inclusion of men aged 65 and older with limited life expectancy.
Main Results:
- 22% of Medicare beneficiaries undergoing prostate biopsy had limited life expectancy (1420 biopsies/100,000).
- This rate remained stable between 1993 and 1997.
- Following biopsy, 1.6% had radical prostatectomy, 2.3% had radiation, and 39% were hospitalized.
Conclusions:
- A significant proportion of prostate biopsies are performed on men unlikely to benefit.
- These procedures and subsequent treatments may offer little advantage to men with limited life expectancy.
