TALLAHASSEE, FL USA (Press Release) - February 12, 2013
New Research Shows Increased Cancer Detection with 10 to 12-core Biopsies
Today, the findings of the largest reported study on prostate biopsies were released at the American Society of Clinical Oncology Genitourinary Cancers Symposium in Orlando. The research confirmed that cancer detection rates are enhanced when 10 to 12-specimens are obtained during the biopsy.
“The study, which included over 4.2 million specimens collected from nearly 440,000 biopsies, confirms that biopsy regimens with 10 to 12 specimen cores results in an increased detection of prostate cancer, ” said Carl A. Olsson, M.D., F.A.C.S., co-author of the study, Chief Medical Officer of Integrated Medical Professionals, PLLC and a pre-eminent thought leader in urologic oncology. “Increased cancer detection rate correlated significantly with increased number of specimens examined.” The study, Utilization and cancer detection by U.S. prostate biopsies (2005-2011), 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 study 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.
Research found 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 between the period 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. “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,” continued Dr. Deepak A. Kapoor, principal author and President of the Large Urology Group Practice Association. “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.”
The American Association of Clinical Urologists (AACU), American Urological Association (AUA), and the Large Urology Group Practice Association (LUGPA) joined together in applauding the release of the findings and stand in support of sampling at least 10 to 12 cores to ensure highest amount of cancers are detected. The 10 to 12 sampling protocol is now a de facto national standard.
Click here to access to the abstract for Utilization and cancer detection by U.S. prostate biopsies (2005-2011).
About LUGPA
LUGPA represents 115 large urology group practices in the United States, with nearly 2,000 physicians who make up more than 20 percent of the nation’s practicing urologists. LUGPA and its member practices are committed to best practices, research, data collection, and benchmarking to promote quality clinical outcomes. For more information, visit lugpa.org for more information.
Large Urology Group Practice Association (LUGPA)
Utilization and cancer detection by U.S. prostate biopsies (2005-2011)
Background: To assess the positive biopsy rate and core sampling pattern in patients undergoing prostate biopsy in the US at a national reference laboratory and pathology laboratories integrated into urology group practices and analyze the relationship between positive biopsy rates and number of specimen vials per biopsy (sv/b).
Methods: For the years 2005-11, we collected pathology data from a national reference laboratory (NRL) including number of urologists and urology practices referring samples, total specimen vials submitted per prostate biopsy, and final diagnosis for each case. The diagnoses were categorized as benign, malignant, prostatic intraepithelial neoplasia or atypical small acinar proliferation. Over the same period, similar data was gathered from urology practices with in-house laboratories performing global pathology services (urology practice labs, UPL) identified by a member survey of the Large Urology Group Practice Association. For each year studied, positive biopsy rate and number of specimen vials/biopsy were calculated in aggregate and separately for each site of service.
Results: From 2005-11, 437,937 biopsies were submitted in 4,230,129 vials (9.4 sv/b); overall positive biopsy rate was 40.3%, identical at both the NRL and UPL (p=0.97). Nationally, the number of specimen vials/biopsy increased sharply from a mean of 8.8 during 2005-8 to 10.3 from 2009-11 (difference 1.5 sv/b, p=0.03). For the most recent 3 year period (2009-11), there was no significant difference between the NRL (10.0 sv/b) and UPL (10.6 sv/b) (p=0.08). Positive biopsy rate correlated strongly (p < 0.01) with number of specimen vials/biopsy.
Conclusions: The positive prostate biopsy rate of 40.3% is identical across sites of service. Although there was a national trend towards increased specimen vials/biopsy from 2005-11, from 2009-11 there was no significant difference in specimen vials/biopsy across sites of service. Increased cancer detection rate correlated significantly with increased number of specimens examined. Segregation of prostate biopsy cores into 10-12 unique specimen vials has been adopted by urologists across sites of service and can be considered the de facto national standard of care.
Authors: Carl A. Olsson, Deepak A. Kapoor, Savvas E. Mendrinos, Ann E. Anderson, David G. Bostwick; Integrated Medical Professionals, PLLC; Columbia University Medical Center, North Hills, NY; Integrated Medical Professionals, PLLC, Melville, NY; Integrated Medical Professionals, PLLC, Garden City, NY; Bostwick Laboratories, Uniondale, NY
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