title: Prostate biopsies in men with limited life expectancy.
abstract: BACKGROUND
  Authorities discourage prostate screening in men who are likely to die from causes other than prostate cancer.
  
  
  METHODS
  Use of prostate biopsy-a proxy for screening-in men aged 65 and older with limited life expectancy (i.e., estimated to be less than 10 years).
  
  
  METHODS
  Five percent samples of Part A (hospital) and Part B (physician) Medicare claims for 1993 through 1997.
  
  
  RESULTS
  22% of all Medicare beneficiaries who underwent a prostate biopsy had a limited life expectancy, corresponding to a rate of 1420 biopsies per 100,000. This rate did not change significantly between 1993 and 1997. For men with a life expectancy greater than 10 years, the biopsy rate was 2,360 per 100,000. Among men with limited life expectancy, in the year following the biopsy, 1.6% had radical prostatectomy and 2.3% had external-beam radiation. Thirty-nine percent were hospitalized.
  
  
  CONCLUSIONS
  A substantial proportion of prostate biopsies are being performed in men with a life expectancy of less than 10 years. These men are unlikely to benefit from the biopsy or subsequent treatment.
authors.affiliation: Center for the Aging, Dartmouth Medical School, Hanover, NH 03755-3862, USA. john.h.wasson@dartmouth.edu
authors.forename: John H
authors.initials: JH
authors.lastname: Wasson
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Bubolz
authors.forename: Grace Lu
authors.initials: GL
authors.lastname: Yao
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Barry
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000706:statistics & numerical data*; D002423:Cause of Death; D003657:Decision Making; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008017:Life Expectancy; D008297:Male; D006278:Medicare; D017410:Practice Guidelines as Topic; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D016896:Treatment Outcome; D014481:United States