title: Use of prostate-specific antigen testing as a disease surveillance tool following radical prostatectomy.
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.
authors.affiliation: Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (UNC-CH), Chapel Hill, North Carolina.
authors.forename: Laurel Clayton
authors.initials: LC
authors.lastname: Trantham
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Nielsen
authors.forename: Lee R
authors.initials: LR
authors.lastname: Mobley
authors.forename: Stephanie B
authors.initials: SB
authors.lastname: Wheeler
authors.forename: William R
authors.initials: WR
authors.lastname: Carpenter
authors.forename: Andrea K
authors.initials: AK
authors.lastname: Biddle
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011159:Population Surveillance; D017430:Prostate-Specific Antigen / Q000032:analysis*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000737:chemistry* / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D012307:Risk Factors; D018426:SEER Program; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D017430:Prostate-Specific Antigen
keywords: population surveillance; practice guidelines as topic; prostate-specific antigen; prostatectomy; prostatic neoplasms
references.citation: Health Care Financ Rev. 2008 Summer;29(4):5-21
references.pmid: 18773611
references.citation: J Clin Oncol. 2007 May 20;25(15):2035-41
references.pmid: 17513807
references.citation: Urol Clin North Am. 2001 Aug;28(3):555-65
references.pmid: 11590814
references.citation: J Natl Cancer Inst. 2003 Nov 19;95(22):1702-10
references.pmid: 14625261
references.citation: Urology. 2010 Feb;75(2):467-71
references.pmid: 19864003
references.citation: J Urol. 1994 Nov;152(5 Pt 1):1358-68
references.pmid: 7523702
references.citation: J Cancer Surviv. 2010 Mar;4(1):59-66
references.pmid: 20091247
references.citation: Cancer Epidemiol Biomarkers Prev. 2005 Mar;14(3):590-5
references.pmid: 15767335
references.citation: JAMA. 2008 Jun 18;299(23):2760-9
references.pmid: 18560003
references.citation: Cancer Causes Control. 2006 Aug;17(6):803-11
references.pmid: 16783608
references.citation: J Natl Compr Canc Netw. 2010 Feb;8(2):145
references.pmid: 20141674
references.citation: BMC Health Serv Res. 2010 Sep 01;10:256
references.pmid: 20809966
references.citation: Biometrics. 2001 Mar;57(1):120-5
references.pmid: 11252586
references.citation: Med Care. 2002 Aug;40(8 Suppl):IV-3-18
references.pmid: 12187163
references.citation: Cancer Causes Control. 2010 Jul;21(7):1071-80
references.pmid: 20333462
references.citation: J Clin Oncol. 2010 Mar 1;28(7):1117-23
references.pmid: 20124165
references.citation: Urology. 2005 Nov;66(5 Suppl):83-94
references.pmid: 16194712
references.citation: JAMA. 1999 May 5;281(17):1591-7
references.pmid: 10235151
references.citation: Cancer. 2012 Nov 15;118(22):5644-51
references.pmid: 22434568
references.citation: Ann Epidemiol. 2007 Aug;17(8):584-90
references.pmid: 17531502
references.citation: BJU Int. 2011 Feb;107(4):576-84
references.pmid: 20735387
references.citation: Health Serv Res. 2010 Feb;45(1):265-82
references.pmid: 19840136
references.citation: Cancer. 2003 Aug 1;98(3):496-503
references.pmid: 12879465