Practice Patterns for Prostate Cancer among Urologists

New Orleans—Opinions vary on whether prostate cancer treatment patterns differ for urologists working in practices with or without the ownership of radiation oncology services. A recent study presented during a session at the AUA 2015 Annual Meeting found that the number of prostate biopsies performed per patient visit were similar among urologists both with and without ownership of a radiation oncology service.

Deborah Kaye, MD, and colleagues obtained a list of 44 urology practices that owned radiation oncology services and compared them to a control group. The researchers compared the two groups on the ratio of prostate biopsies performed compared to total patient visits, as well as the ratio of radical prostatectomies performed compared to the number of prostate biopsies.

In April 2014, the Centers for Medicare & Medicaid Services released the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File, which included data for 8792 urologists who participated in Medicare in 2012. The researchers used this data to determine the number of overall patient visits, total prostate biopsies, and total radical prostatectomies performed.

In the cohort with urology practices that owned radiation oncology services, 796 urologists were included, with a total of 893,012 total patient visits. In that group, 14,373 total prostate biopsies were performed, including 1023 radical prostatectomies performed. Comparatively, the control group included 7996 urologists and a total of 7,396,825 total patient visits. In addition, the control group had a total of 111,635 total prostate biopsies performed and 9145 total radical prostatectomies performed.

The researchers found that the number of prostate biopsies performed per patient visit was similar for both the urology practice-owned radiation oncology services and the control group (0.016 vs 0.015, respectively). However, the urology practice-owned radiation oncology services performed 13% fewer radical prostatectomies per prostate biopsy (0.071) compared with the control group (0.082).

The researchers noted a limitation of the study, including that the public use file lacked clinical variable information necessary to identify differences across the patient population.

Source: Kaye D, DeWeese T, Chalfin H, et al. Does the ownership of radiation oncology services affect urologists’ practice patterns for the treatment of prostate cancer? Abstract of a presentation at the American Urological Association 2015 Annual Meeting, New Orleans, Louisiana, May 16, 2015.