Prostate biopsies in men with limited life expectancy.
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.
Wasson
John H
JH
Center for the Aging, Dartmouth Medical School, Hanover, NH 03755-3862, USA. john.h.wasson@dartmouth.edu
Bubolz
Thomas A
TA
Yao
Grace Lu
GL
Barry
Michael J
MJ
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