Patients who undergo prostate MRI for low-risk prostate cancer more likely to receive observation
Patients who undergo prostate MRI in the time surrounding a prostate cancer diagnosis are much more likely to receive observation, according to a new study published in Urology.
“Despite national declines in screening, prostate cancer remains the most commonly diagnosed non-cutaneous cancer among men in the United States,” wrote lead author Michael S. Leapman, MD, department of urology at Yale School of Medicine in New Haven, Connecticut, and colleagues. “For those with low-risk features, immediate treatment has not been shown to improve cancer-specific survival, and frequently impacts health-related quality of life including urinary, bowel, and sexual function. Active surveillance (AS), a period of close disease observation, has emerged as a strategy to defer or avoid definitive treatment for low-risk patients, and is now regarded as the standard of care by major cancer guideline-issuing bodies.”
The authors examined Medicare data from more than 8,000 patients with low-risk prostate cancer. These are just some of the team’s findings:
- More than 6 percent of those patients underwent MRI in the time surrounding their diagnosis.
- More than 37 percent of patients with low-risk prostate cancer received observation within 12 months of their diagnosis.
- Rates of immediate prostate cancer treatment decreased from more than 69 percent in 2010 to 52 percent in 2013
- As the number of patients undergoing prostate MRI is on the rise—going from more than 3 percent in 2010 to 10.5 percent in 2013—patients diagnosed with prostate cancer annually has decreased.
Leapman and colleagues also noted some key statistics related to the initial management of patients who undergo prostate MRI.
“Patients who received prostate MRI were significantly more likely to receive observation,” the authors wrote. “In addition, non-white race, older age, being unmarried, low clinical stage, and residence in a region with higher urologist density were significantly associated with the likelihood of receiving observation versus definitive treatment.”
The researchers also noted that more and more studies are confirming the safety of AS. In addition, though prostate MRI does come with its own additional costs, it can still lead to potential cost savings if the likelihood of each patient receiving AS does increase.
“Despite initial high costs associated with obtaining and interpreting MRI studies of the prostate, economic modeling studies imply that MRI would be cost-effective if it resulted in increased utilization of AS for low and very-low risk prostate cancer,” the authors concluded. “The association identified in our study between MRI use and initial observation may serve as an informative basis for examining strategies to improve the quality of prostate cancer care with the anticipated growing use of this technology.”
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.