National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Events (2)
- Cancer (10)
- Cancer: Breast Cancer (1)
- Cancer: Colorectal Cancer (1)
- (-) Cancer: Prostate Cancer (24)
- Cardiovascular Conditions (2)
- Care Management (2)
- Chronic Conditions (1)
- Clinician-Patient Communication (1)
- Comparative Effectiveness (6)
- Decision Making (2)
- Diabetes (1)
- Diagnostic Safety and Quality (2)
- Elderly (10)
- Falls (1)
- Healthcare Costs (3)
- Healthcare Utilization (3)
- Health Status (1)
- Hospitalization (1)
- Medicare (5)
- Medication (3)
- Men's Health (4)
- Mortality (1)
- Outcomes (1)
- Palliative Care (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (7)
- Patient and Family Engagement (1)
- Patient Experience (1)
- Practice Patterns (2)
- Prevention (1)
- Primary Care (2)
- Quality of Life (3)
- Racial and Ethnic Minorities (1)
- Screening (5)
- Substance Abuse (1)
- Surgery (5)
- Treatments (1)
- U.S. Preventive Services Task Force (USPSTF) (2)
- Women (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 24 of 24 Research Studies DisplayedMisra-Hebert AD, Hu B, Klein EA
Prostate cancer screening practices in a large, integrated health system: 2007-2014.
The researchers assessed prostate cancer screening practices in primary care since the initial United States Preventive Services Task Force (USPSTF) recommendation against prostate-specific antigen (PSA) testing for older men. Prostate cancer screening declined from 2007 to 2014 even in higher-risk groups and follow-up screening rates were not related to previous PSA level.
AHRQ-funded; HS024128.
Citation: Misra-Hebert AD, Hu B, Klein EA .
Prostate cancer screening practices in a large, integrated health system: 2007-2014.
BJU Int 2017 Aug;120(2):257-64. doi: 10.1111/bju.13793.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Prostate Cancer, Screening, Primary Care, Practice Patterns
Tyson MD, Alvarez J, Koyama T
Racial variation in patient-reported outcomes following treatment for localized prostate cancer: results from the CEASAR study.
This study tested the hypothesis that treatment-related changes in urinary, bowel, sexual, and hormonal function vary by race/ethnicity. It concluded that the effect of treatment for prostate cancer on patient-reported function did not vary dramatically by race/ethnicity. Compared to white men, African-American men experienced a somewhat more pronounced decline in urinary continence after radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: Tyson MD, Alvarez J, Koyama T .
Racial variation in patient-reported outcomes following treatment for localized prostate cancer: results from the CEASAR study.
Eur Urol 2017 Aug;72(2):307-14. doi: 10.1016/j.eururo.2016.10.036.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Racial and Ethnic Minorities, Surgery
Winters-Stone KM, Moe E, Graff JN
Falls and frailty in prostate cancer survivors: current, past, and never users of androgen deprivation therapy.
This study compared the prevalence of and association between falls and frailty of prostate cancer survivors (PCSs) who were current, past or never users of androgen deprivation therapy (ADT). It concluded that current and past exposure to ADT is linked to higher risk of falls and frailty than no treatment.
AHRQ-funded; HS022981.
Citation: Winters-Stone KM, Moe E, Graff JN .
Falls and frailty in prostate cancer survivors: current, past, and never users of androgen deprivation therapy.
J Am Geriatr Soc 2017 Jul;65(7):1414-19. doi: 10.1111/jgs.14795.
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Keywords: Cancer: Prostate Cancer, Cancer, Falls, Medication, Elderly
Jayadevappa R, Chhatre S, Wong YN
Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: a systematic review and meta-analysis (PRISMA compliant).
This review analyzed the comparative effectiveness of prostate cancer (PCa) treatments through systematic review and meta-analysis with a focus on outcomes that matter most to newly diagnosed localized PCa patients. The studies provided moderate data for the patient-centered outcome of mortality. Radical prostatectomy demonstrated mortality benefit compared to watchful waiting and radiation therapy.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Chhatre S, Wong YN .
Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: a systematic review and meta-analysis (PRISMA compliant).
Medicine 2017 May;96(18):e6790. doi: 10.1097/md.0000000000006790.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer, Cancer: Prostate Cancer
Chen RC, Basak R, Meyer AM
Association between choice of radical prostatectomy, external beam radiotherapy, brachytherapy, or active surveillance and patient-reported quality of life among men with localized prostate cancer.
This study compared quality of life after radical prostatectomy, external beam radiotherapy, and brachytherapy vs active surveillance. By 24 months, mean scores between treatment groups vs active surveillance were not significantly different in most domains. However, each treatment strategy was associated with distinct patterns of adverse effects over 2 years.
AHRQ-funded; AHRQ contract (no number given).
Citation: Chen RC, Basak R, Meyer AM .
Association between choice of radical prostatectomy, external beam radiotherapy, brachytherapy, or active surveillance and patient-reported quality of life among men with localized prostate cancer.
JAMA 2017 Mar 21;317(11):1141-50. doi: 10.1001/jama.2017.1652.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Surgery, Quality of Life
Barocas DA, Alvarez J, Resnick MJ
Association between radiation therapy, surgery, or observation for localized prostate cancer and patient-reported outcomes after 3 years.
This study compares functional outcomes and adverse effects associated with radical prostatectomy, external beam radiation therapy (EBRT), and active surveillance. It concluded that radical prostatectomy was associated with a greater decrease in sexual function and urinary incontinence than either EBRT or active surveillance after 3 years and was associated with fewer urinary irritative symptoms than active surveillance.
AHRQ-funded; HS019356; HS022640.
Citation: Barocas DA, Alvarez J, Resnick MJ .
Association between radiation therapy, surgery, or observation for localized prostate cancer and patient-reported outcomes after 3 years.
JAMA 2017 Mar 21;317(11):1126-40. doi: 10.1001/jama.2017.1704.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Adverse Events, Cancer: Prostate Cancer, Surgery
Eifler JB, Alvarez J, Koyama T
More judicious use of expectant management for localized prostate cancer during the last 2 decades.
Urologists have been criticized for overtreating men with low risk prostate cancer and for passively observing older men with higher risk disease. Proponents of active surveillance for low risk disease and critics of watchful waiting for higher risk disease have advocated for more judicious use of observation. In this study, the investigator compared 2 population based cohorts to determine how expectant management has evolved during the last 2 decades.
AHRQ-funded; HS019356; HS022640.
Citation: Eifler JB, Alvarez J, Koyama T .
More judicious use of expectant management for localized prostate cancer during the last 2 decades.
J Urol 2017 Mar;197(3 Pt 1):614-20. doi: 10.1016/j.juro.2016.10.067..
Keywords: Cancer, Cancer: Prostate Cancer, Care Management, Diagnostic Safety and Quality, Men's Health
Tsai HT, Philips G, Taylor KL
Utilization and predictors of expectant management among elderly men with low-and intermediate-risk localized prostate cancer in U.S. urological practice.
Researchers assessed the use and predictors of expectant management (EM) to understand its uptake in U.S. practice. In U.S. practice, the utilization of EM steadily increased in low-risk prostate cancer and remained low in the intermediate-risk group over time. While patients with advanced age or comorbidities were more likely to receive EM, its use varied substantially by geographic region.
AHRQ-funded; HS022915.
Citation: Tsai HT, Philips G, Taylor KL .
Utilization and predictors of expectant management among elderly men with low-and intermediate-risk localized prostate cancer in U.S. urological practice.
Urol Pract 2017 Mar;4(2):132-39. doi: 10.1016/j.urpr.2016.05.005.
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Keywords: Decision Making, Elderly, Healthcare Utilization, Cancer: Prostate Cancer, Practice Patterns
Scherr KA, Fagerlin A, Hofer T
Physician recommendations trump patient preferences in prostate cancer treatment decisions.
This study assessed the influence of patient preferences and urologist recommendations in treatment decisions for clinically localized prostate cancer. It found that patients' initial treatment preferences did not predict receipt of active treatment versus surveillance. Instead, receipt of active treatment was predicted primarily by urologists' recommendations.
AHRQ-funded; HS021764.
Citation: Scherr KA, Fagerlin A, Hofer T .
Physician recommendations trump patient preferences in prostate cancer treatment decisions.
Med Decis Making 2017 Jan;37(1):56-69. doi: 10.1177/0272989x16662841.
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Keywords: Cancer: Prostate Cancer, Decision Making, Patient and Family Engagement, Patient-Centered Healthcare, Clinician-Patient Communication
Raval AD, Mattes MD, Madhavan S
Association between metformin use and cancer stage at diagnosis among elderly Medicare beneficiaries with preexisting Type 2 diabetes mellitus and incident prostate cancer.
The researchers examined the association between metformin use and cancer stage at diagnosis among elderly men with preexisting diabetes mellitus and incident prostate cancer. They found a significantly lower percentage of metformin users were diagnosed with advanced prostate cancer as compared to nonusers (4.7 percent versus 6.7 percent.
AHRQ-funded; HS018622.
Citation: Raval AD, Mattes MD, Madhavan S .
Association between metformin use and cancer stage at diagnosis among elderly Medicare beneficiaries with preexisting Type 2 diabetes mellitus and incident prostate cancer.
J Diabetes Res 2016;2016:2656814. doi: 10.1155/2016/2656814.
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Keywords: Cancer: Prostate Cancer, Medication, Elderly, Diabetes, Medicare
Raval AD, Madhavan S, Mattes MD
Association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer.
The current retrospective observational study was conducted to examine the association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer. It found that those with none of the 3 types of chronic conditions (cardiometabolic, mental health, and respiratory) were 44 percent more likely to be diagnosed with advanced prostate cancer compared to men with all 3 types of chronic conditions.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Association between types of chronic conditions and cancer stage at diagnosis among elderly Medicare beneficiaries with prostate cancer.
Popul Health Manag 2016 Dec;19(6):445-53. doi: 10.1089/pop.2015.0141.
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Keywords: Cancer, Cancer: Prostate Cancer, Elderly, Medicare
Jayadevappa R, Chhatre S
Association between age, substance use, and outcomes in Medicare enrollees with prostate cancer.
The authors analyzed the association between age, substance use, and outcomes in fee-for-service Medicare enrollees with advanced prostate cancer. As they found age-specific results, they recommend an integrated and multidisciplinary approach to screen, refer, and treat substance use in patients with prostate cancer to improve outcomes and reduce costs.
AHRQ-funded; HS024106.
Citation: Jayadevappa R, Chhatre S .
Association between age, substance use, and outcomes in Medicare enrollees with prostate cancer.
J Geriatr Oncol 2016 Nov;7(6):444-52. doi: 10.1016/j.jgo.2016.06.007.
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Keywords: Elderly, Medicare, Outcomes, Cancer: Prostate Cancer, Substance Abuse
Goodwin JS, Sheffield K, Li S
Receipt of cancer screening is a predictor of life expectancy.
The researchers sought to determine the association between receipt of screening mammography or PSA and overall survival. They found that the subjects with prior cancer screening had actual median survivals higher than those who were not screened, with differences ranging from 1.7 to 2.1 years for women and 0.9 to 1.1 years for men.
AHRQ-funded; HS022134.
Citation: Goodwin JS, Sheffield K, Li S .
Receipt of cancer screening is a predictor of life expectancy.
J Gen Intern Med 2016 Nov;31(11):1308-14. doi: 10.1007/s11606-016-3787-y.
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Keywords: Cancer, Cancer: Breast Cancer, Cancer: Prostate Cancer, Screening, Women, Men's Health, Health Status
Sohn W, Resnick MJ, Greenfield S
Impact of adherence to quality measures for localized prostate cancer on patient-reported health-related quality of life outcomes, patient satisfaction, and treatment-related complications.
Given the small number of narrowly focused measures in prostate cancer care, the researchers sought to determine whether adherence to any of the available payer-driven quality measures influences patient-centered outcomes, including health-related quality of life (HRQOL), patient satisfaction, and treatment-related complications. They concluded that compliance with available nationally endorsed quality indicators was not associated with clinically important changes in patient-centered outcomes (HRQOL, satisfaction, or complications) within 1-year.
AHRQ-funded; HS019356; HS022640.
Citation: Sohn W, Resnick MJ, Greenfield S .
Impact of adherence to quality measures for localized prostate cancer on patient-reported health-related quality of life outcomes, patient satisfaction, and treatment-related complications.
Med Care 2016 Aug;54(8):738-44. doi: 10.1097/mlr.0000000000000562.
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Keywords: Cancer, Cancer: Prostate Cancer, Quality of Life, Comparative Effectiveness, Patient Experience
Roth JA, Gulati R, Gore JL
Economic analysis of prostate-specific antigen screening and selective treatment strategies.
The researchers evaluated the potential cost-effectiveness of plausible prostate-specific antigen (PSA) screening strategies and assessed the value added by increased use of conservative management among low-risk, screen-detected cases. They found that, with contemporary treatment, only strategies with biopsy referral for PSA levels higher than 10.0 ng/mL or age-dependent thresholds were associated with increased quality-adjusted life-years (QALYs), and only quadrennial screening of patients aged 55 to 69 years was potentially cost-effective in terms of cost per QALY. They concluded that, for PSA screening to be cost-effective, it needs to be used conservatively and ideally in combination with a conservative management approach for low-risk disease.
AHRQ-funded; HS022982.
Citation: Roth JA, Gulati R, Gore JL .
Economic analysis of prostate-specific antigen screening and selective treatment strategies.
JAMA Oncol 2016 Jul;2(7):890-8. doi: 10.1001/jamaoncol.2015.6275.
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Keywords: Healthcare Costs, Prevention, Cancer: Prostate Cancer, Quality of Life, Screening
Raval AD, Madhavan S, Mattes MD
Types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer.
The authors sought to examine the association between types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer. They found that a significant proportion of elderly men with chronic conditions have received aggressive initial cancer treatment, and they suggested a conservative approach for the initial prostate cancer treatment among elderly men with significant chronic conditions and localised prostate cancer.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Types of chronic conditions combinations and initial cancer treatment among elderly Medicare beneficiaries with localised prostate cancer.
Int J Clin Pract 2016 Jul;70(7):606-18. doi: 10.1111/ijcp.12838.
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Keywords: Cancer, Cancer: Prostate Cancer, Care Management, Chronic Conditions, Elderly, Men's Health
Bhatia N, Santos M, Jones LW
Cardiovascular effects of androgen deprivation therapy for the treatment of prostate cancer: ABCDE steps to reduce cardiovascular disease in patients with prostate cancer.
Since cardiovascular disease risk may be increased by the use of androgen deprivation therapy (ADT), the researchers have adapted the five-step "ABCDE" algorithm for prostate cancer survivors. Its treatment recommendations come under the following headings: awareness and aspirin, blood pressure, cholesterol and cigarettes, diet and diabetes, and exercise. The algorithm is illustrated by a hypothetical case study.
AHRQ-funded; HS022990.
Citation: Bhatia N, Santos M, Jones LW .
Cardiovascular effects of androgen deprivation therapy for the treatment of prostate cancer: ABCDE steps to reduce cardiovascular disease in patients with prostate cancer.
Circulation 2016 Feb 2;133(5):537-41. doi: 10.1161/circulationaha.115.012519.
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Keywords: Cardiovascular Conditions, Cancer: Prostate Cancer, Diagnostic Safety and Quality, Medication, Patient-Centered Outcomes Research
Raval AD, Madhavan S, Mattes MD
Impact of prostate cancer diagnosis on noncancer hospitalizations among elderly Medicare Beneficiaries with incident prostate cancer.
The authors analyzed the impact of cancer diagnosis on noncancer hospitalizations (NCHs) by comparing these hospitalizations between the precancer and postcancer periods. They found that the rate of NCHs was higher during the postcancer period compared with the precancer period. They suggested that their study highlights the need to design interventions for reducing the excess NCHs after prostate cancer diagnosis among elderly men.
AHRQ-funded; HS018622.
Citation: Raval AD, Madhavan S, Mattes MD .
Impact of prostate cancer diagnosis on noncancer hospitalizations among elderly Medicare Beneficiaries with incident prostate cancer.
J Natl Compr Canc Netw 2016 Feb;14(2):186-94.
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Keywords: Elderly, Hospitalization, Medicare, Cancer: Prostate Cancer
Dinan MA, Li Y, Zhang Y
Resource use in the last year of life among patients who died with versus of prostate cancer.
The researchers conducted a retrospective analysis of Surveillance, Epidemiology, and End Results-Medicare data of men with prostate cancer. Patients who died of prostate cancer rather than from other causes had more hospice and outpatient use, less inpatient and ICU use, and lower overall costs. Efforts to shift care toward outpatient settings might provide more efficient and judicious care for patients during the end of life.
AHRQ-funded; HS022189.
Citation: Dinan MA, Li Y, Zhang Y .
Resource use in the last year of life among patients who died with versus of prostate cancer.
Clin Genitourin Cancer 2016 Feb;14(1):28-37.e2. doi: 10.1016/j.clgc.2015.07.006.
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Keywords: Cancer, Cancer: Prostate Cancer, Healthcare Costs, Healthcare Utilization, Men's Health, Mortality, Palliative Care, Patient-Centered Outcomes Research
O'Neil B, Koyama T, Alvarez J
The comparative harms of open and robotic prostatectomy in population based samples.
Using population cohort data,the researchers examined sexual and urinary function in men undergoing open radical prostatectomy vs those undergoing robotic assisted radical prostatectomy. They found that men undergoing robotic assisted radical prostatectomy likely experience less decline in early urinary continence and sexual function than those undergoing open radical prostatectomy.
AHRQ-funded; HS019356; HS022640.
Citation: O'Neil B, Koyama T, Alvarez J .
The comparative harms of open and robotic prostatectomy in population based samples.
J Urol 2016 Feb;195(2):321-9. doi: 10.1016/j.juro.2015.08.092.
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Keywords: Comparative Effectiveness, Patient-Centered Outcomes Research, Cancer: Prostate Cancer, Surgery, Adverse Events
Shen C, Tina Shih YC
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
The authors studied the impact of the fast diffusion of robotic surgical systems on the overall treatment pattern of localized prostate cancer. They found that the density of robotic systems at state-level had a significantly positive impact on the rate of surgery and a significantly negative impact on the rate of radiation therapy. They concluded that part of the increase in the rate of surgery was driven by substitution across treatment types with a large proportion originating from the younger population.
AHRQ-funded; HS018535; HS020263.
Citation: Shen C, Tina Shih YC .
Therapeutic substitutions in the midst of new technology diffusion: the case of treatment for localized prostate cancer.
Soc Sci Med 2016 Feb;151:110-20. doi: 10.1016/j.socscimed.2016.01.016.
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Keywords: Surgery, Cancer: Prostate Cancer, Cancer, Healthcare Costs, Treatments
Zanwar P, Lin YL, Kuo YF
Downstream tests, treatments, and annual direct payments in older men cared for by primary care providers with high or low prostate-specific antigen screening rates using 100 percent Texas U.S. Medicare public insurance claims data: a retrospective cohort
The investigators assessed the tests, treatments, and payments for prostate cancer care in men aged 75 or older who have primary care physicians (PCPs) with high or low prostate specific antigen (PSA) testing rates. They found that older men seeing PCPs with high rates of PSA testing undergo more testing and treatments for prostate cancer, with higher Medicare insurance payments.
AHRQ-funded; HS022134.
Citation: Zanwar P, Lin YL, Kuo YF .
Downstream tests, treatments, and annual direct payments in older men cared for by primary care providers with high or low prostate-specific antigen screening rates using 100 percent Texas U.S. Medicare public insurance claims data: a retrospective cohort
BMC Health Serv Res 2016 Jan 15;16:17. doi: 10.1186/s12913-016-1265-1.
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Keywords: Elderly, Medicare, Primary Care, Cancer: Prostate Cancer, Screening
Garcia-Albeniz X, Hsu J, Lipsitch M
Infective endocarditis and cancer in the elderly.
The researchers investigated the magnitude of the association between infective endocarditis and cancer, and the natural history of cancer patients with concomitant diagnosis of infective endocarditis. They found that in this elderly population, the incidence of infective endocarditis around a colorectal cancer diagnosis was substantially higher than around the diagnosis of lung, breast and prostate cancers.
AHRQ-funded; HS023128.
Citation: Garcia-Albeniz X, Hsu J, Lipsitch M .
Infective endocarditis and cancer in the elderly.
Eur J Epidemiol 2016 Jan;31(1):41-9. doi: 10.1007/s10654-015-0111-9.
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Keywords: Cancer, Cancer: Colorectal Cancer, Cardiovascular Conditions, Elderly, Cancer: Prostate Cancer
Rezaee ME, Ward CE, Odom BD
Prostate cancer screening practices and diagnoses in patients age 50 and older, Southeastern Michigan, pre/post 2012.
This study investigated the regional impact of the 2012 U.S. Preventive Services Task Force (USPSTF) recommendation against the use of prostate specific antigen (PSA) screening for prostate cancer. PSA utilization significantly increased during the pre-period, but significantly decreased in the post-period. Prostate biopsies decreased before the 2012 recommendation and did not change afterwards.
AHRQ-funded; HS000084.
Citation: Rezaee ME, Ward CE, Odom BD .
Prostate cancer screening practices and diagnoses in patients age 50 and older, Southeastern Michigan, pre/post 2012.
Prev Med 2016 Jan;82:73-6. doi: 10.1016/j.ypmed.2015.11.017.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Cancer: Prostate Cancer, Screening, Elderly, Healthcare Utilization