National Trends in Prostate Biopsy and Radical Prostatectomy Volumes Following the US Preventive Services Task Force Guidelines Against Prostate-Specific Antigen Screening.
Studies demonstrate that use of prostate-specific antigen screening decreased significantly following the US Preventive Services Task Force (USPSTF) recommendation against prostate-specific antigen screening in 2012.



To determine downstream effects on practice patterns in prostate cancer diagnosis and treatment following the 2012 USPSTF recommendation.



Procedural volumes of certifying and recertifying urologists from 2009 through 2016 were evaluated for variation in prostate biopsy and radical prostatectomy (RP) volume. Trends were confirmed using the New York Statewide Planning and Research Cooperative System and Nationwide Inpatient Sample. The study included a representative sample of urologists across practice settings and nationally representative sample of all RP discharges. We obtained operative case logs from the American Board of Urology and identified urologists performing at least 1 prostate biopsy (n = 5173) or RP (n = 3748), respectively.



The 2012 USPSTF recommendation against routine population-wide prostate-specific antigen screening.



Change in median biopsy and RP volume per urologist and national procedural volume.



Following the USPSTF recommendation, median biopsy volume per urologist decreased from 29 to 21 (interquartile range [IQR}, 12-34; P < .001). After adjusting for physician and practice characteristics, biopsy volume decreased by 28.7% following 2012 (parameter estimate, -0.25; SE, 0.03; P < .001). Similarly, following the USPSTF recommendation, median RP volume per urologist decreased from 7 (IQR, 3-15) to 6 (IQR, 2-12) (P < .001), and in adjusted analyses, RP volume decreased 16.2% (parameter estimate, -0.15; SE, 0.05; P = .003).



Following the 2012 USPSTF recommendation, prostate biopsy and RP volumes decreased significantly. A panoramic vantage point is needed to evaluate the long-term consequences of the 2012 USPSTF recommendation.
Department of Urology, Weill Cornell Medicine, New York, New York.
Joshua A
JA
Halpern
Department of Urology, Weill Cornell Medicine, New York, New York.
Jonathan E
JE
Shoag
Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, New York.
Amanda S
AS
Artis
Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, New York.
Karla V
KV
Ballman
Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, New York.
Art
A
Sedrakyan
Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, New York, New York.
Dawn L
DL
Hershman
Herbert Irving Comprehensive Cancer Center, Columbia University College of Physicians and Surgeons, New York, New York.
Jason D
JD
Wright
Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston.
Ya Chen Tina
YC
Shih
Department of Urology, Weill Cornell Medicine, New York, New York.
Jim C
JC
Hu
D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D008297:Male; D009518:New York; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods / Q000706:statistics & numerical data* / Q000639:trends; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000601:surgery*; D014481:United States; D014572:Urology / Q000639:trends*
D017430:Prostate-Specific Antigen