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. 2023 Sep;29(6):893-902.
doi: 10.1111/jep.13791. Epub 2022 Nov 14.

Increased magnetic resonance imaging in prostate cancer management-What are the outcomes?

Bjørn Hofmann  1   2 , Erik Skaaheim Haug  3   4   5 , Eivind Richter Andersen  1 , Elin Kjelle  1
Affiliations

Increased magnetic resonance imaging in prostate cancer management-What are the outcomes?

Bjørn Hofmann et al. J Eval Clin Pract. 2023 Sep.

Abstract

Rationale: Increased attention to cancer care has instigated altered systems for screening, diagnosis, and management of various types of cancer, such as in the prostate. While such systems very likely have improved the quality of cancer care, they also result in the altered use of specific services, such as magnetic resonance imaging (MRI).

Aims and objective: To study the change in the use of prostate MRI in the Norwegian health care system from 2013 to 2021 and to investigate some reasons for and potential implications of this change.

Method: Data from the Norwegian Health Economics Administration (HELFO), The Cancer Registry of Norway and Cause-of-death registry at the Norwegian Institute of public health and the health registry of Vestfold Hospital Trust were used for descriptive statistical analysis.

Results: The number of MRIs of the prostate increased threefold from 2013 to 2021, representing an extra cost of 2 million USD in 2020. The incidence of prostate cancer was stable at about 5000 cases per year, corresponding to 178 per 100,000 men, indicating no increased overdiagnosis. However, the clinical staging has changed substantially during this period, indicating stage and grade migration. The number of negative biopsies was reduced, and there are three MRIs per reduced negative biopsy. The number of persons on active surveillance increased during the period. However, these changes are partly independent of the increase in the number of MRIs.

Conclusion: There was a substantial increase in the number of prostate MRIs and thus an increase in costs. This appears to have contributed to the reduction of negative biopsies, improved staging and increased active surveillance. However, as these effects are partly independent of the increase in MRIs, we need to document the outcomes for patients from prostate MRIs as their opportunity costs are substantial.

Keywords: evaluation; health services research; practical reasoning.

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References

REFERENCES

    1. Culp MB, Soerjomataram I, Efstathiou JA, Bray F, Jemal A. Recent global patterns in prostate cancer incidence and mortality rates. Eur Urol. 2020;77(1):38-52.
    1. Löffeler S, Halland A, Weedon-Fekjaer H, Nikitenko A, Ellingsen CL, Haug ES. High Norwegian prostate cancer mortality: evidence of over-reporting. Scand J Urol. 2018;52(2):122-128.
    1. Drost FJH, Osses DF, Nieboer D, et al. Prostate MRI, with or without MRI-targeted biopsy, and systematic biopsy for detecting prostate cancer. Cochrane Database Syst Rev. 2019;4(4):CD012663.
    1. The Cancer Registry of Norway. The Cancer Registry of Norway Online Statistics. Secondary The Cancer Registry of Norway Online Statistics. The Cancer Registry of Norway; 2021. https://sb.kreftregisteret.no/insidens/
    1. Norwegian Institute of Public Health. Cause-of-death registry at the Norwegian Institute of Public Health. Secondary Cause-of-death registry at the Norwegian Institute of Public Health. Norwegian Institute of Public Health; 2021.

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