PCa detection enhanced with 10-12 biopsy specimens

A large study presented at the Genitourinary Cancers Symposium in Orlando, FL has confirmed that prostate cancer detection rates are enhanced when 10 to 12 specimens are obtained during biopsy.

"Increased cancer detection rate correlated significantly with increased number of specimens examined," said co-author Carl A. Olsson, MD, of Integrated Medical Professionals, LLC, New York.

The study, which included more than 4.2 million specimens collected from nearly 440,000 biopsies, assessed positive biopsy rates and core sampling patterns in patients whose prostate biopsies were submitted to either a national reference laboratory (NRL) or laboratory integrated into a urology group practice (UPL). The authors analyzed the relationship between positive biopsy rates and number of specimen vials per biopsy. The vials per biopsy were calculated in aggregate and separately for each site of service.

The results showed that from 2005-’11, the average positive prostate biopsy rate of 40.3% was identical at both the NRL and UPL. Furthermore, the sharpest increase in the number of specimen vials obtained per biopsy was noted during the period of 2005-’08, corresponding to the development of extended core sampling regimens. The study showed that at present, there is no significant difference in number of specimen vials submitted per biopsy, regardless of site of service, Dr. Olsson and colleagues reported.

"This data, which represents the work product of over 2,000 urologists, indicates that physicians modified their clinical patterns to reflect best practices as suggested by the peer-reviewed literature," said principal author Deepak A. Kapoor, MD, of Integrated Medical Professionals. "The fact that there was no difference in either positive biopsy rate or specimen vials submitted across sites of service definitively demonstrates that appropriate medical necessity, not physician ownership, determines utilization of services."

Look for additional coverage of the Genitourinary Cancers Symposium in an upcoming issue of Urology Times.