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Results Conclusions• Active surveillance rates to

be as low as 14% in eligible patients with low-risk prostate cancer

• The variation in receipt of AS was attributable to facility related factors such as facility type, facility volume, and the institution

• Additionally, policy makers need to address the variation in care at Commission on Cancer facilities

• Reports on the use of active surveillance for localized prostate cancer have been conflicting

• There is a growing need for studies that identify sources of non-clinical variation across all clinical settings and specialties

Purpose & Hypothesis• Goal: To evaluate the contemporary use of

active surveillance for men with low-risk prostate cancer

• Hypothesis: A wide variation exists in institutional practices and the use of active surveillance in the community remains unfortunately low

Patients & Methods• N=40,215 low risk prostate cancer patients

from 2012 to 2013 retrieved from the National Cancer Data Base

• Chi-square test and the Mann-Whitney test were used to compare baseline variables

• Logistic regression model was fitted to predict the odds of receiving active surveillance

• A mixed-effects logistic regression was performed to assess association of patient and hospital variable with active surveillance

AcknowledgementsThank you to…• Björn Löppenberg, MD; • Quoc-Dien Trinh, MD; • Emily McMains Ph.D; • Karen Burns White; • Stephania Libreros, Ph.D;• Danielle Cook, Ph.D;• Continuing Umbrella of Research

Experience Program;• Funding support from:

• Biogen Foundation• National Cancer Institute Cancer Center Support Grant;

• Dana-Farber Harvard Cancer Center;• Brigham and Women’s Hospital

Variation in the Use of Active Surveillance for Low-Risk Prostate CancerHawa Barry1,2; Björn Löppenberg, MD2; Quoc-Dien Trinh, MD1,2

1. Dana-Farber Harvard Cancer Center 2. Brigham and Women’s Hospital Center for Surgery and Public Health, Division of Urologic Surgery

Figure 1: Receipt of active surveillance ranged from 0 to 100% over facilities with 14% of eligible men, receiving active surveillance

Figure 2: Very high volume facilities are 2.6 times more like likely to use active surveillance (95% CI 2.34-2.90; p<0.001)

Figure 3: Community Cancer Programs and Academic facilities are 2.1 times and 1.76 times more likely to utilize active surveillance (95% CI 1.85-2.38; and 1.63-1.91; with p<0.001, respectively)

Table 1: The single facility accounted for 35% of unexplained association with the use of active surveillance

Background

Variation in the Use of Active Surveillance for Low-Risk Prostate Cancer

Hawa Barry1,2; Björn Löppenberg, MD2; Quoc-Dien Trinh, MD1,2


cure poster presentation_v8

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