Abstract: PD40-10
Sources of Funding: None

Introduction

In the 2012 US Preventative Services Task Force (USPSTF) recommendation against prostate specific antigen (PSA) screening, it was acknowledged that African American men represented a disproportionately small minority of the population analyzed. We sought to describe the prostate biopsy practice patterns before and after the recommendation in an inner city hospital that serves a high risk patient population of predominantly Afro Caribbean descent.

Methods

A retrospective chart review of patients who underwent prostate biopsy from 10/27/2008 to 12/15/2015 was performed. Patients were grouped into those who underwent biopsy prior to, and after the new USPSTF guidelines (5/22/2012). Patient and clinical characteristics were compared between the two time periods. Bivariate analyses included two sample t tests, chi square tests, and the Mann Whitney U tests.

Results

Our analysis revealed no significant differences in the age, percent of positive biopsies, or type of physician initiating screening. There was a significant difference in median PSA (p= 0.05) and a trend toward significance in the difference in racial distribution between the two groups (p=0.06). Among those with positive biopsies, patients biopsied after the recommendation had significantly greater core positivity, and a borderline significantly higher incidence of clinically significant disease defined by D Amico criteria (p=0.24)

Conclusions

In a high risk patient population, we found that men biopsied after the USPSTF recommendation were more likely to have a higher PSA level, more likely to be African American, had greater core positivity, and a higher incidence of clinically significant disease. These results suggest that high risk patients in an inner city setting are also being negatively affected by the implementation of the task force recommendations. Further research is required to determine whether the practice pattern change occurred at the level of PSA screening or rather at patient selection for prostate biopsy. Such research will allow clinicians to provide more granular counseling with regards to PSA screening and prostate biopsies for high risk patients.

Funding

None