Influence of life expectancy on shared decision-making for prostate cancer screening.

Purpose: The U.S. Preventive Services Task Force recommends that men aged 55-69 years undergo shared decision-making (SDM) regarding prostate cancer (PCa) screening, and routine screening is not recommended for older men or those with limited life expectancy.

Grade Group 1 Prostate Cancer Outcome by Biopsy Grade and Risk Group.

Importance: Advocates for removing the cancer label from grade group 1 (GG1) prostate cancer detected on biopsy primarily base their argument on the observation that when only GG1 is detected on prostatectomy, rates of metastasis are rare. However, the frequency with which GG1 prostate cancer on biopsy is associated with adverse clinical features and the long-term cancer outcomes in this context are poorly defined.

Objective: To assess cancer-specific outcomes of localized GG1 prostate cancer stratified by risk category.

Increasing Utilization of Sedation for Prostate Biopsies: National Trends, Predictors, and Patient Cost.

Objective: To describe national trends, predictors, insurance, and patient costs associated with sedation use during prostate biopsies.

Methods: We conducted a retrospective cohort study using the Merative Marketscan Database from 2016 to 2021. Men undergoing prostate biopsy were identified using CPT codes.

Trends in stage-specific prostate cancer incidence by neighborhood socioeconomic status.

Changes in screening guidelines have influenced stage at diagnosis for prostate cancer, but it remains unclear whether these trends differ by neighborhood socioeconomic status (SES). Using cancer registry data from the Surveillance, Epidemiology, and End Results program from 2011 to 2020, we estimated age-standardized stage-specific incidence rates and annual percent changes for localized and distant prostate cancer incidence by neighborhood SES quintile and age group. Incidence of localized prostate cancer was highest in higher neighborhood SES areas, while distant prostate cancer rates were highest in areas with lowest neighborhood SES.

Health literacy and all-cause mortality among cancer patients.

Background: The association between health literacy and all-cause mortality among cancer patients remains unclear.

Methods: This is a retrospective cohort study of 9603 patients diagnosed with prostate, lung, breast, renal, colorectal, brain, head and neck, bladder, pancreatic, liver, sarcoma, and gastric cancers who were screened for health literacy between 2008 and 2018, using the Brief Health Literacy Screen (BHLS). Higher scores (range, 3-15) indicate higher health literacy.

Patient-reported functional outcomes and treatment-related regret in Hispanic and Spanish-speaking men following prostate cancer treatment.

Objectives: Compare functional outcomes and treatment-related regret over 10 years in Spanish- and English-speaking Hispanic men compared to non-Hispanic men following treatment of localized prostate cancer.

Methods And Materials: Data from a prospective cohort study of men with localized prostate cancer treated with active surveillance, radical prostatectomy or radiotherapy were used to examine the effect of survey language (Spanish speaking vs. English speaking) and ethnicity (Hispanic vs.

Factors affecting the non-publication of clinical trials of prevalent urological cancer.

Objectives: Clinical trials (CTs) are critical in understanding and managing cancer. However, despite being completed, CT results are often unpublished, compromising the ability to glean useful information from them. This study aimed to evaluate factors influencing the non-publication of urological oncology clinical trials.

Racial and Ethnic Variation in Receipt and Intensity of Active Surveillance for Older Patients With Localized Prostate Cancer.

Introduction: The use of active surveillance (AS) for prostate cancer is increasing, and racial disparities have been identified in its implementation. We investigated differences by race and ethnicity in the utilization and intensity of AS by race and ethnicity among older men with low- and favorable intermediate-risk prostate cancer, with particular focus on the integration of multiparametric MRI (mpMRI) into AS protocols.

Methods: Using the Surveillance, Epidemiology, and End Results and Medicare fee-for-service linked database, we identified a cohort of men diagnosed between 2010 and 2017 with low- or favorable intermediate-risk prostate cancer.

Functional Outcomes After Localized Prostate Cancer Treatment.

Importance: Adverse outcomes associated with treatments for localized prostate cancer remain unclear.

Objective: To compare rates of adverse functional outcomes between specific treatments for localized prostate cancer.

Design, Setting, And Participants: An observational cohort study using data from 5 US Surveillance, Epidemiology, and End Results Program registries.

Understanding the Termination of Urologic Cancer Clinical Trials: Insights and Challenges.

Purpose: Clinical trials are valuable evidence for managing urologic malignancies. Early termination of clinical trials is associated with a waste of resources and may substantially affect patient care. We sought to study the termination rate of urologic cancer clinical trials and identify factors associated with trial termination.

Trends, Cost, and Predictors of Local Hemostatics Use in Major Urological Surgery.

Introduction: The national usage and cost trends associated with hemostatic agents in major urologic procedures remain unknown. This study aims to describe the trends, costs, and predictors of local hemostatic use in major urologic surgeries.

Methods: We utilized the Premier Healthcare Database to analyze 385,261 patient encounters between 2000 and 2020.

Adoption and Outcomes of Holmium Laser Enucleation of the Prostate in the United States.

Objective: To investigate the utilization of holmium laser enucleation of the prostate (HoLEP) using a large real-world cohort. We compare the safety, readmission, and retreatment rates of HoLEP to other widely used endoscopic surgical interventions for benign prostatic hyperplasia (BPH) including transurethral resection of the prostate (TURP), photoselective vaporization of the prostate, and prostatic urethral lift.

Methods: Men who underwent endoscopic treatments for BPH from 2000 to 2019 were identified in the Premier Healthcare Database (n = 218,793).

Projected Savings for Generic Oncology Drugs Purchased via Mark Cuban Cost Plus Drug Company Versus in Medicare.

Purpose: Self-administered oncology drugs contribute disproportionately to Medicare Part D spending; prices often remain high even after generic entry. Outlets for low-cost drugs such as Mark Cuban Cost Plus Drug Company (MCCPDC) offer opportunities for decreased Medicare, Part D, and beneficiary spending. We estimate potential savings if Part D plans obtained prices such as those offered under the MCCPDC for seven generic oncology drugs.

Impact of Magnetic Resonance Imaging Targeting on Pathologic Upgrading and Downgrading at Prostatectomy: A Systematic Review and Meta-analysis.

Context: The evidence supporting multiparametric magnetic resonance imaging (MRI) targeting for biopsy is nearly exclusively based on biopsy pathologic outcomes. This is problematic, as targeting likely allows preferential identification of small high-grade areas of questionable oncologic significance, raising the likelihood of overdiagnosis and overtreatment.

Objective: To estimate the impact of MRI-targeted, systematic, and combined biopsies on radical prostatectomy (RP) grade group concordance.

The lived experience of prostate cancer: 10-year survivor perspectives following contemporary treatment of localized prostate cancer.

Purpose: Studies relying on standardized instruments to measure patient-centered harms and benefits of cancer treatment may fail to capture important elements of the lived experience of cancer patients. Further, qualitative studies on the survivorship experience of men with localized prostate cancer (PCa) are limited. We sought to explore the early experience, long-term experience, and advice provided for others among long-term survivors of localized PCa.

Novel Therapies for High-Risk Non-Muscle Invasive Bladder Cancer.

Purpose Of Review: The treatment options for high-risk non-muscle invasive bladder cancer (NMIBC), particularly following BCG, remain limited. We highlight recent, promising therapies for high-risk NMIBC.

Recent Findings: Several therapies utilizing different mechanisms of action have demonstrated favorable results in the BCG-naïve and BCG-unresponsive settings.