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. 2013 Oct 1;119(19):3523-30.
doi: 10.1002/cncr.28238. Epub 2013 Jul 24.

Use of prostate-specific antigen testing as a disease surveillance tool following radical prostatectomy

Laurel Clayton Trantham  1 , Matthew E Nielsen, Lee R Mobley, Stephanie B Wheeler, William R Carpenter, Andrea K Biddle
Affiliations

Use of prostate-specific antigen testing as a disease surveillance tool following radical prostatectomy

Laurel Clayton Trantham et al. Cancer. .

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.

Keywords: population surveillance; practice guidelines as topic; prostate-specific antigen; prostatectomy; prostatic neoplasms.

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Figures

Figure 1
Figure 1
Sample Counts for Included and Excluded Observations Figure shows the number of men excluded at each stage in the sample creation process. SEER: Surveillance, Epidemiology, and End Results; HMO: Health maintenance organization; ESRD: End-stage renal disease; FFS: Fee-for-service.
Figure 2
Figure 2
Percentage of Sample Receiving at Least One Surveillance Prostate-specific Antigen Test:

  1. Selected Year of Diagnosis

  2. Race/ethnicity

Figures show the percentage of the sample receiving at least one prostate-specific antigen test in each year following initial treatment. In Figure 2(a) the sample is separated by year of diagnosis (for selected years) and in Figure 2(b) the sample is divided by race/ethnicity.
Figure 2
Figure 2
Percentage of Sample Receiving at Least One Surveillance Prostate-specific Antigen Test:

  1. Selected Year of Diagnosis

  2. Race/ethnicity

Figures show the percentage of the sample receiving at least one prostate-specific antigen test in each year following initial treatment. In Figure 2(a) the sample is separated by year of diagnosis (for selected years) and in Figure 2(b) the sample is divided by race/ethnicity.
See this image and copyright information in PMC

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